Suggest treatment for urinary tract infection in an infant

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Posted on Tue, 11 Nov 2014 in Child Health
Question: My 9 month old sin has UTI. The leucocyte count was 357/HPF. The paedetrician has presribed cefixime syrup. He has been having fever ranging from 100.5 - 102.5. For that i am using crocin and diclofenac solution(only when the feer is above 102).
Please suggest if the treatment being given is apt or if any admission would be suggested to give the antibiotics through vein.
doctor
Answered by Dr. Sumanth Amperayani 4 hours later
Brief Answer:
Please get back with answers

Detailed Answer:
Hi XXXX... Hope your son's skin issue is settled.
This is UTI or urinary tract infection as you said. If the kid is active and playful and oral intake is good, no harm in giving oral Cefixime. He needs an ultrasound though, to see if there is acute pyelonephritis or upper UTI.
My questions -
1. Has a culture been done in urine before starting antibiotic cefixime?
2. How is his oral intake?
3. I'd there incessant vomiting?
4. How is his activity?
5. Had an ultrasound of abdomen been done?
6. How many days of feveeryis it now?
7. Has a blood test CBC been ordered?

Please get back with answers.

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumanth Amperayani 3 hours later
Thanks for the reply doctor.Answers below.

1. Yes. Awaiting the report.
2. Oral intake is good now.
3. Not much. But vomited couple of times yesterday when we force fed him with excessive water.
4. Once the fever subsides he is active like before and goes back to crying once it comes back.
5. No ultrasound has been prescribed.
6. It's his 3rd day. First observed on Thursday evening.but since yesterday night 2 AMNo fever.
7. No CBC has been presribed.
doctor
Answered by Dr. Sumanth Amperayani 1 hour later
Brief Answer:
Continue with oral Cefixime

Detailed Answer:
Hi...My suggestions are like this -
1. Please continue with oral Cefixime. Your pediatrician is right in doing a culture before starting an antibiotic and definitely a kid who is able to accept oral medication is fit to take. No need for IV antibiotics. No need for admission.

2. If I were you pediatrician, I would also do a CBC to see how the blood differential count is and and also an ultrasound abdomen to see if there are any structural anomalies in the urinary tract.

3. I would give the antibiotic for a total of 14 days based on the culture reports.

4. 4-6 weeks down the line, I would ask yo to do a DMSA scan to see if there is any renal scarring due to the after effects of UTI.

5. If its abnormal I would also prefer to do a MCU scan to see if the urine is going upwards and a reflux is there are not.

Kindly keep me posted on the culture reports and also further proceeding as suggested.

I wish your kid a speedy recovery. If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. Please find the link below.
www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumanth Amperayani 42 minutes later
Thank you very much doctor. Your answers have been really helpful. I will do as yoy suggested.
doctor
Answered by Dr. Sumanth Amperayani 5 minutes later
Brief Answer:
If you are happy... rate my answer

Detailed Answer:
Hi....I am happy and contented when Mt patients say that they are happy. If you are happy, kindly rate my answers.
You can also contact me directly through the link I have provided in my suggestion.
Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumanth Amperayani 10 hours later
One last question, The doctor suggested a fluid intake of 850 ml a day and we are trying to do that. But a little online researched showed that it may lead to water intoxication. Is that true. Do you recommend giving fluids to a 9-month old. By the way he is on solid foods and breast milk.
doctor
Answered by Dr. Sumanth Amperayani 6 hours later
Brief Answer:
850ml water doesn't cause water intoxication

Detailed Answer:
Hi ...it is true that giving water is good for urinary tract infection, because it is assumed that it will drain away the organisms from the tract. But no need to forcibly give water as it might lead to vomiting and decreased food intake.

850 ml of water per day will not cause water intoxication in a 9 month old. Do not worry. He will pass good amount of urine that's all.

But as he's already on solid food and breast milk, if he's passing good amount of urine, no need to push in more fluids.

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Sumanth Amperayani

Pediatrician, Pulmonology

Practicing since :2003

Answered : 8156 Questions

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