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Pediatría (Asunción)
On-line version ISSN 1683-9803
Abstract
FLORENTIN DE MERECH, Leticia; GARCIA BELLENZIER, Víctor and FRANCO VALDEZ, Miguel. Urinary Tract Infection: Relevant Facts and Update. Pediatr. (Asunción) [online]. 2014, vol.41, n.1, pp.57-64. ISSN 1683-9803.
The focus of this article is on changes that have occurred in recent years in the management of urinary-tract infections in children. In the past, independently of age and gender, studies such as cystourethrogram were performed systematically to detect uropathies such as vesicoureteral reflux, which were considered to cause kidney damage, and that when surgically corrected could prevent nephropathy caused by reflux. With advances in knowledge of the pathophysiology of urinary tract infection, prenatal ultrasound monitoring, and new research studies, it became apparent that other factors existed that could produce renal scarring or other renal damage, such as acute pyelonephritis, due to alteration of the innate immunity of the urinary tract system, prenatal congenital scars, or reflux unrelated to scarring. The term scarring nephropathy acquires more relevance than reflux nephropathy, with indications for cystourethrograms becoming more restricted. Renal scintigraphy with dimercaptosuccinic acid (DMSA), which is highly sensitive for renal scars, is becoming more widely used. The current trend is toward individualized assessment of each patient, with only the studies that provide the data most relevant for knowing how to protect the kidneys, and which do the least harm, being requested. One very important strategy recommended for preventing acquired kidney damage is the use of antibiotics when any suspicion of urinary tract infection exists. This article addresses both antibiotic prophylaxis and the question of oral versus parenteral antibiotic administration.
Keywords : Urinary tract infection; pyelonephritis acute; innate immunity; cicatrix; renal injury; cystourethrography; renal scintigraphy; dimercaptosuccinic acid (DMSA); prophylaxis, antibiotics.
