Case 4: A 3 yo female presents with fever, dysuria, and frequency for about 2 days. Mother report she cries when she urinates.
Case 4: A 3 yo female presents with fever, dysuria, and frequency for about 2 days. Mother report she cries when she urinates. The mother reports child does not have any nausea or vomiting. She reports she is allergic to Penicillin.
Cephalosporins, nitrofurantoin, and trimethoprim-sulfamethoxazole are common substitutes as the patient is allergic to Penicillin. To ensure efficiency against common bacterial strains in the population, the local antibiogram should be considered while selecting an antibiotic. A combination antibiotic called trimethoprim-sulfamethoxazole works by stopping the development of bacteria by focusing on two distinct stages in the folic acid production pathway. Another option are beta-lactam antibiotics called cephalosporins, which prevent the formation of bacterial cell walls. An antibiotic called nitrofurantoin is only meant to treat infections of the urinary system. It works by preventing bacteria from metabolizing. The primary treatment for a UTI in children is usually a course of antibiotics, other consideration should be increased fluid intake encourage the child to drink plenty of fluids to help flush out bacteria from the urinary tract. Pain relievers such as Acetaminophen or ibuprofen may be recommended to alleviate discomfort and reduce fever (Leung et al., 2020).
Commonly prescribed antibiotics for pediatric UTIs include Cephalosporins, Nitrofurantoin or trimethoprim-sulfamethoxazole. The choice depends on factors such as the specific bacteria causing the infection and any known allergies (AAFP, 2023).
For children with simple UTIs, a treatment of TMP-SMX usually lasts 7 to 10 days. To determine the exact period, the healthcare provider evaluates variables such as the child’s reaction and the severity of the infection. Cephalosporin courses typically last between seven and fourteen days. The length of treatment depends on the cephalosporin that is prescribed and the severity of the UTI, highlighting the significance of customized treatment regimens. Courses of nitrofurantoin usually last between five and seven days (AAFP, 2023).
Clearly define the proper administration of the recommended antibiotic. Emphasize the significance of following the recommended dosage and schedule and offer advice on whether to take the drug with food. This reduces the possibility of dosage errors and guarantees maximum efficacy. Stress the significance of finishing the whole antibiotic course, even if the child’s symptoms indicate improvement. This is essential to fully eradicate the illness and stop the emergence of strains that are resistant to antibiotics. Describe how taking the drug off too soon could leave behind bacteria and cause the infection to return. Inform parents of any possible negative effects that may arise from taking the recommended antibiotic. Allergic reactions or stomach pain are common side effects. Stress how important it is to stay well-hydrated in order to support the treatment. Drinking enough water enhances the antibiotic’s potency by removing bacteria from the urinary tract. Urge parents to make sure their youngster consumes enough water while undergoing treatment. Stress the value of keeping your planned follow-up appointments with the doctor. These consultations are critical for tracking the child’s development, verifying that the infection has resolved, and discussing any issues or modifying the treatment plan as needed. Reiterate that receiving follow-up care is essential to managing UTIs completely. Give advice on how to lower the chance of recurring UTIs in the future. This could entail encouraging frequent bathroom visits, assuring prompt diaper changes to reduce bacterial exposure, and promoting excellent hygiene practices (Kaufman et al., 2020).
Prescription for Urinary Tract Infection is as follows:
Patient name – 3 Year old Female
Age – 3 years
Allergy – Penicillin
Diagnosis – Urinary Tract Infection
Medication – Sulfamethoxazole/Trimethoprim (Bactrim) (40mg/200mg)/5ml
Directions – 8 mg/kg by mouth divided every 12 hours for 14 days
Quantity – 8 mg/kg
Refills – None
Additional direction – Take with food for GI side effects, shake the bottle before each use
Dispense as written
Signature – Providers Name, Title, Contact information
References
American Academy of Family Physicians. (2023). Treatment of UTI: JNC 7 Reconsidered. American Family Physician. https://www.aafp.org/pubs/afp/issues/2011/0215/p409.html#treatment
Kaufman, J., Temple-Smith, M., & Sanci, L. (2020). Urinary tract infections in children: an overview of diagnosis and management. BMJ paediatrics open, 3(1), e000487. https://doi.org/10.1136/bmjpo-2019-000487
Leung, A. K. C., Wong, A. H. C., Leung, A. A. M., & Hon, K. L. (2020). Urinary Tract Infection in Children. Recent patents on inflammation & allergy drug discovery, 13(1), 2–18. https://doi.org/10.2174/1872213X13666181228154940
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