Urinary Tract Infection in Children - December 15, 2005 -- American Family Physician
A review article in American Family Physician reports that children with uncomplicated UTI's show no benefit from imaging work-ups. While it may be true that imaging may reveal relatively common vesicourethral reflux or, less commonly, subsequent renal scarring leading to potential adult hypertension, effective treatments for these conditions are wonting, and clinical efficacy for the tests has not been shown. Older children with classic symptoms of UTI were best served by initial urine cultures and empiric antibiotics, while infants with unexplained fever and older children with nonclassic symptoms did best with initial dipstick testing.
A negative dipstick result can effectively rule out UTI. Physicians are free to treat positive cultures for as long as they want, as long as it lasts more than one day. Cranberry juice has not been shown to be effective in preventing UTI's. Although circumcision has been shown to reduce the incidence of UTI's, the benefit (from this aspect alone) is clearly insufficient to warrant the procedure.