1 - Área da Mulher, Criança e Adolescente, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, EPE
2 - Unidade de Nefrologia – Área da Mulher, Criança e Adolescente, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, EPE
- Abstract published Notas de Pediatria 2019
Abstract: Urinary tract infection is common in the pediatric population. Since repeated episodes of pyelonephritis are associated with an increased risk of renal scarring, the identification of risk factors and the adoption of preventive measures is required. Bladder and bowel dysfunction affects approximately half of the children with recurrent urinary tract infection and is often underdiagnosed. It is characterized by an abnormal vesical and intestinal elimination pattern, manifesting as lower urinary tract symptoms and functional constipation. Treatment of this condition has the greatest influence in the prophylaxis of urinary infection and should include actions that impact the level of bladder emptying, feeding and constipation. Indications for prophylactic antibiotic therapy in urinary tract infection have undergone several updates in the last decade, follo- wing results from randomized control studies. Its use should be restricted to specific conditions such as recurrent urinary tract infection, severe vesicoureteral reflux, bladder and bowel dysfunction, obstructive uropathy or until cystography is performed. Other strategies have been used in the prophylaxis of urinary infection, such as postcoital voiding, cranberry products, pro- biotics, vitamin C and bacterial extracts. Formulations with cran- berries and OM-89 may play a role in the prevention of urinary tract infection, however more studies are required to assess its efficacy.
Keywords: antibiotic prophylaxis, bladder and bowel dysfunction, urinary tract infection, paediatric, vesico-ureteral reflux