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Evidence behind the WHO Guidelines: Hospital care for children: What is the appropriate empiric antibiotic therapy in uncomplicated urinary tract infections in children in developing countries?
Journal of Tropical Pediatrics. 2007 Jun; 53(3):150-152.Urinary tract infection (UTI) is an important cause of morbidity and mortality in children. Studies from developing countries show that the around 10% of children with febrile illnesses have UTI . Studies have shown a higher UTI prevalence of 8-35% in malnourished children. The risk of developing UTI before the age of 14 is ~1% in boys and 3-5% in girls. Due to lack of overt clinical features in children less than 2 years, appropriate collection of urine samples and basic diagnostic tests at first-level health facilities in developing countries, UTI are not generally reported as a cause of childhood mortality. If poorly treated or undiagnosed, UTI is an important cause of long-term morbidities such as hypertension, failure to thrive and end-stage renal disease. Unfortunately, many of the organisms responsible for UTI in developing and industrialized countries have become resistant to first-line antimicrobials. It is thus necessary to establish the type of pathogen and antimicrobial sensitivities in the local environment in order to treat the UTI with the appropriate antibiotic. (excerpt)