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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2015.1
- 수록면
- 56 - 64 (9page)
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초록· 키워드
오류제보하기
To revise the clinical guideline for childhood urinary tract infections (UTIs) of the Korean Society of Pediatric Nephrology (2007), the recently updated guidelines and new data were reviewed.
The major revisions are as follows. In diagnosis, the criterion for a positive culture of the catheterized or suprapubic aspirated urine is reduced to 50,000 colony forming uits (CFUs)/mL from 100,000 CFU/mL. Diagnosis is more confirmatory if the urinalysis is abnormal. In treating febrile UTI and pyelonephritis, oral antibiotics is considered to be as effective as parenteral antibiotics. In urologic imaging studies, the traditional aggressive approach to find primary vesicoureteral reflux (VUR) and renal scar is shifted to the targeted restrictive approach. A voiding cystourethrography is not routinely recommended and is indicated only in atypical or complex clinical conditions, abnormal ultrasonography and recurrent UTIs. 99mTc-DMSA renal scan is valuable in diagnosing pyelonephritis in children with negative culture or normal RBUS. Although it is not routinely recommended, normal scan can safely avoid VCUG. In prevention, a more natural approach is preferred. Antimicrobial prophylaxis is not supported any more even in children with VUR. Topical steroid (2-4 weeks) to non-retractile physiologic phimosis or labial adhesion is a reasonable first-line treatment. Urogenital hygiene is important and must be adequately performed. Breast milk, probiotics and cranberries are dietary factors to prevent UTIs. Voiding dysfunction and constipation should be properly treated and prevented by initiating toilet training at an appropriate age (18-24 months). The follow-up urine test on subsequent unexplained febrile illness is strongly recommended. Changes of this revision is not exclusive and appropriate variation still may be accepted.
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참고문헌 (25)
참고문헌 신청
/ 2011 / Clinical practice guideline for the diagnosis and management of the initial urinary tract infection in febrile infants and young children 2-24 months / Pediatrics 12
Al-Orifi / 2000 / Urine culture from bag specimens in young children: are the risks too high? / J Pediatr 137 : 221 ~ 226
Ammenti A / 2012 / Italian Society of Pediatric Nephrology. Febrile urinary tract infections in young children. Recommendation for the diagnosis, treatment and follow-up / Ac
Bocquet N / 2012 / Randomized trial of oral versus sequential IV/oral antibiotics for acute pyelonephritis in children / Pediatrics 129 : e269 ~ e275
Boggan JC / 2012 / Pediatric specific antimicrobial susceptibility data and empiric antibiotic selection / Pediatrics 130 : e615 ~ e622
Al-Orifi / 2000 / Urine culture from bag specimens in young children: are the risks too high? / J Pediatr 137 : 221 ~ 226
Ammenti A / 2012 / Italian Society of Pediatric Nephrology. Febrile urinary tract infections in young children. Recommendation for the diagnosis, treatment and follow-up / Ac
Bocquet N / 2012 / Randomized trial of oral versus sequential IV/oral antibiotics for acute pyelonephritis in children / Pediatrics 129 : e269 ~ e275
Boggan JC / 2012 / Pediatric specific antimicrobial susceptibility data and empiric antibiotic selection / Pediatrics 130 : e615 ~ e622
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