抗生素PPT课件（英文精品）Risk factors for .pptVIP

* * * * * * * * * * * * * * * * * * * * * * * * * 2007 Risk factors for UTI Poor urine flow Previous proved or suspected UTI Recurrent fever of unknown origin Antenatally diagnosed renal abnormality Family history of vesico-ureteric reflux constipation Risk factors for UTI Dysfunctional voiding Enlarged bladder Abdominal mass Evidence of spinal lesion Poor growth high blood pressure Urine sampling A clean catch sample should be obtained If not possible Use non invasive method i.e. Urine collection pad Do not use cotton wool balls, gauze or sanitary towels. If non invasive method not possible Use catheter sample or suprapubic aspiration Symptoms and signs Age 3/12 Most common Fever, vomiting, lethargy, irritability Less common Poor feeding, failure to thrive Least common Abdominal pain, jaundice, haematuria, offensive urine. Symptoms and signs Age 3/12 preverbal Most common Fever Less common Abdominal pain, loin tenderness, vomiting, poor feeding. Least common Lethargy, irritability, haematuria, offensive urine, failure to thrive. Symptoms and signs Age 3/12 verbal Most common Frequency, dysuria Less common Dysfunctional voiding, changes to continence. Abdominal pain, loin tenderness. Least common Fever, malaise, vomiting, haematuria, offensive urine, cloudy urine Microscopy results Pyuria positive Pyuria negative Bacteria positive Treat as though has UTI Treat as though has UTI Bacteria negative Antibiotic treatment to start if clinically has UTI Treat as though does not have UTI Management 3/12 Refer to paediatricians Management Age 3/12 3yrs Specific urinary symptoms Urine for urgent cs Start antibiotic treatment Management Age 3/12 3yrs Non specific symptoms high risk of serious illness Urgent referral to paeds Urine for cs Manage in line with guidelines for feverish illness in children Management Age 3/12 3yrs non specific symptoms Intermediate risk of serious illness Consider urgent referral paeds If referral not required Urgent urine cs Start antibio