Urinary tract infection in infants and children. Preventing recurrence and renal damage.

The major goal in treating urinary tract infection in children is to preserve renal parenchyma. Therefore, children with suspected pyelonephritis or anatomic abnormalities need to be examined thoroughly with the first infection. Any child with three infections should have intravenous pyelography and voiding cystourethrography, even if infections appear to be limited to the lower urinary tract. Recurrence of urinary tract infections is a major problem, and a program of follow-up urine cultures should be instituted after the first infection. Such an approach allows for early detection of anatomic abnormalities or reinfection, thus preventing loss of renal parenchyma and hence of renal function.