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[儿童尿路感染诊断与治疗管理共识会议的建议]

[Recommendations of the consensus conference "diagnostic and therapeutic management of urinary tract infection in childhood"].

作者信息

Ochoa Sangrador C, Málaga Guerrero S

机构信息

Servicio de Pediatría, Hospital Virgen de la Concha, Zamora, España.

出版信息

An Pediatr (Barc). 2007 Nov;67(5):517-25.

Abstract

The recommendations of the Consensus Conference "Diagnostic and Therapeutic Management of Urinary Tract Infection in Childhood" are presented. Selection of the most appropriate urine collection technique depends on the child's ability to control urination and the urgency of the diagnosis. Directives for the interpretation of the various parameters of urinalysis are offered with the recommendation that diagnosis of urinary tract infection be based on urine culture. The indication of hospitalization does not depend on the location of the urinary tract infection but on the severity of repercussions and the risk of complications. Guidelines for first choice and alternative antibiotic therapy for parenteral or oral administration are established, as well as recommendations for the choice of route, type of regimen and the duration of the treatment, based on the patient's level of risk. Routine antibiotic prophylaxis is not recommended in children with a normal urinary tract after a first episode of urinary tract infection or in those with low-grade vesicoureteral reflux; the indication of prophylaxis in patients with recurrent infections or with high-grade reflux must be individualized. The current strategy of routine use of diagnostic imaging tests should be substituted by another strategy in which the use of these tests is individualized, taking into account each patient's level of risk.

摘要

本文介绍了“儿童尿路感染的诊断与治疗管理共识会议”的建议。选择最合适的尿液采集技术取决于儿童控制排尿的能力和诊断的紧迫性。提供了尿液分析各项参数的解读指南,并建议尿路感染的诊断应基于尿培养。住院指征不取决于尿路感染的部位,而是取决于反响的严重程度和并发症的风险。制定了肠外或口服给药的首选和替代抗生素治疗指南,以及基于患者风险水平的给药途径、治疗方案类型和治疗持续时间的选择建议。对于首次尿路感染后尿路正常的儿童或低度膀胱输尿管反流的儿童,不建议常规使用抗生素预防;复发性感染或高度反流患者的预防指征必须个体化。当前常规使用诊断性影像学检查的策略应被另一种策略取代,即在考虑每个患者风险水平的情况下,对这些检查的使用进行个体化。

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