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Pediatric Urinary Tract Infections

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Urinary infections are one of the most common infections found in children. Read the article below to know more.

Written by

Dr. Kriti Singh

Medically reviewed by

Dr. Veerabhadrudu Kuncham

Published At November 17, 2022
Reviewed AtMarch 22, 2023


Urinary tract infection is one of the most common infections in children and a significant cause of childhood morbidity. Children between three to twelve months are more commonly affected. The urinary tract consists of the body part involved in urine formation. It consists of two kidneys, two ureters, a bladder, and a urethra.

The kidney helps in the filtration of blood and extra water, resulting in the formation of urine. The kidneys take urine to the bladder with the help of the ureter. The urine is stored in the bladder until it is removed from the body. Then, the urine is removed from the bladder with the help of a tube known as the urethra. If the bacterial infection occurs in the urinary tract and urethra, it results in a urinary tract infection.

What Are the Types of Urinary Tract Infections?

There are two types of urinary tract infections found in toddlers.

  • Lower Urinary Tract infection - It is also known as cystitis. Infection is found in the urinary bladder.

  • Upper Urinary Tract infection - It is also known as pyelonephritis. Infection is found in the kidney.

  • Urethritis - Infection is found in the urethra.

What Are the Causes of Urinary Tract Infections?

Urinary tract infection is caused by bacteria that enter the skin into the urinary tract. Then, bacteria begin to multiply in the bladder. Colonic bacterias mainly cause infection. Next, bacteria colonize the periurethral area and ascend to the bladder. Finally, it spreads through the urinary tract to the kidney, causing bacteremia.

Following are the species of bacteria which cause urinary tract infections.

  • Escherichia coli.

  • Klebsiella.

  • Proteus.

  • Enterococcus species.

  • Staphylococcus saprophyticus.

  • Streptococcus group B.

  • Pseudomonas aeruginosa.

What Are the Clinical Features of Urinary Tract Infections?

The sign and symptoms of infection depend upon the severity of the disease. Infants and young children are unable to describe the symptoms. Therefore, parents should observe the child rule out the infection.

Following are the signs and symptoms of urinary tract infection.

Cystitis: The infection is seen in the urinary bladder.

  • Presence of fever.
  • Babies appear to be fussy.
  • Vomiting.
  • Children use the bathroom often, but they pass tiny amounts of urine.
  • Children wet themselves more often.
  • Pain and burning sensation during urination.
  • Presence of abdominal pain and back pain.
  • Presence of blood in the urine.
  • Irritability.
  • Nausea.
  • Chills with shaking.
  • Severe Fatigue.
  • Skin appears to be flushed and warm.
  • Diarrhea.

Pyelonephritis: The infection occurs in the kidney.

  • High fever.
  • Chills are shaking, along with nausea and vomiting.
  • Pain and pressure are present in the lower back, lower pelvis, and the region below the navel.
  • The urine appears to be cloudy.
  • The urine smells foul.
  • There is a burning and stinging sensation during urination.
  • The child wakes up frequently from sleep for urination.
  • The child feels the need for frequent urination with minimal urine output.
  • Even after proper toilet training, children wet themselves.

What Are the Risk Factors for Urinary Tract Infections?

Following are the risk factors for urinary tract infections.

  • Girls are more susceptible to infection because the urethra is closer to the anus. Bacteria can reach to urethra easily.

  • Boys below the age of one year are at higher risk of urinary tract infection.

  • Presence of any structural deformity.

  • Vesicoureteral reflux is a congenital disability that causes the abnormal backward flow of urine.

  • Abnormal functioning of the urinary tract.

  • Tight-fitting clothes for girls.

  • Improper wiping after a bowel movement.

  • Poor hygiene.

  • Poor Toilet

  • Infrequent urination.

  • Delaying urination for a more extended period.

  • Lack of circumcision in boys.

  • Improper toilet training.

  • Bubble bath.

  • Constipation.

  • Family history of urinary tract infections.

What Are the Complications Caused by Urinary Tract Infection?

Proper diagnosis and treatment of urinary tract infections are essential as it causes various complications.

Following are the complications of urinary tract infections.

How Is Pediatric Urinary Infection Treated?

Children suffering from urinary tract infections are treated by antibiotic therapy. The treatment plan depends upon the severity of the infection. Painkillers are given to relieve pain in the abdomen and back. If the infection is less severe, it can be treated with oral medication; however, intravenous fluids and hospitalization are required if the infection is severe. The commonly used antibiotics to treat urinary tract infections are.

  • Amoxicillin

  • Clavulanic acid.

  • Cephalosporin.

  • Doxycycline.

  • Nitrofurantoin.

  • Sulfamethoxazole trimethoprim.

How Is Pediatric Urinary Tract Infection Prevented?

Parents can take the following measures to prevent urinary tract infections.

  • Fluid Intake - Parents should ensure that their child drinks plenty of water.

  • Emptying the Bladder - Parents should ensure that a child's bladder is empty while urinating. Children sometimes do not open their bladders after peeing. Holding on to the urine for more extended time tightens the bladder muscles. Parents should practice double peeing when their child goes for urination. Double peeing is going to urinate a second time immediately for urine discharge.

  • Potty Session - Parents should train their children for the potty session. It is essential to maintain a schedule, and the bladder should be empty often.

  • Wiping - Parents should wipe their children properly. It should be done from front to back motion. Parents should avoid using toilet tissue to wipe their bottom and urethral area.

  • Clothing - Parents should avoid wearing tight clothes. Undergarments made up of cotton fabric are recommended. Tight clothes affect circulation resulting in the perfect environment for bacterial growth. The child's undergarments should not be wet as moisture promotes bacterial growth.

  • Avoid Bubble Baths - Parents should avoid bubble baths for their children. A bubble bath should contain frothy particles, leading to skin irritation on and around the genitalia.


Urinary tract infection is one of the most common infections that is painful and uncomfortable for children. Children are too young to voice their symptoms if they suffer from the infection. Parents should observe and take care of their children. It needs to be treated immediately to prevent damage to the kidneys. With proper treatment, all the symptoms of urinary tract infections clear up. Parents should be able to recognize the signs and symptoms of urinary tract infection and visit a pediatrician as early as possible.

Frequently Asked Questions


When to Suspect The Child Has a UTI?

When the child feels pain, burning, or tingling feeling while urinating can lead to suspicion of UTI. Often urinating and feeling an urgent sensation to urinate without passing urine. Foul-smelling urine may look cloudy or sometimes have blood, along with fever.


What Is the Most Common Urinary Tract Infection in Children?

The most common urinary tract infection is caused by E. coli bacteria. These are normally found in stool. The bacteria can move from the anus to the urethra and into the bladder leading to infection.


What Is the Best Antibiotic for Urinary Tract Infections in Children?

Initial antibiotics in most pediatric UTI cases are trimethoprim and sulfamethoxazole. Alternative antibiotics are amoxicillin and clavulanic or cephalosporins.


What Is a Common Cause of Urinary Tract Infections in Pediatric Patients?

The most common cause of UTI in children is caused by digestive tract bacteria. The most common bacteria involved are E.coli. These bacteria typically live in the colon.


What Are the Signs of Urine Infection in a Child?

The most specific signs of urine infection in a child are pain or burning sensation while peeing, deliberating holding pee, the urgency to pee frequently, pain in the tummy, unpleasant smelling pee, and change in normal toilet habits.


Why Do Kids Keep Getting UTI?

Children hold urine too long. They don’t relax while fully urinating. And do not empty the bladder. Regular urination flushes away bacteria, and holding urine helps the bacteria to increase and grow. A child who does not consume enough fluid may not make enough urine to flush away bacteria.


Can Kids Recover From UTI Without Antibiotics?

UTIs in kids need the doctor's attention. These infections won’t get better on their own. They are easy to treat and usually clear up in a week. Taking antibiotics helps in killing germs and getting rid of the infection soon.


Can UTI Affect a Child’s Behavior?

Yes, UTI can affect a child’s behavior. Fever and pain can cause irritability. Older children and teens are likely to show more signs of UTI, like pain and frequent urination.


What Happens if a UTI Goes Untreated in Children?

If UTI is left untreated, the infection penetrates the kidney, causing inflammation that leads to high fever and renal damage. Untreated and recurrent UTIs can lead to kidney damage. The younger the child, the more damage.


Can a Child’s UTI Go Away on Its Own?

No, a child’s UTI won’t go away on its own, it requires immediate doctor’s medical attention. Administration of antibiotics can help to get rid of the infection sooner.


How Do You Test a 4-Year-Old for UTI?

A 4-year-old can have symptoms like fever and throwing up. A home test kit can help to identify the UTI and confirm the diagnosis.


What Does a UTI Look Like in a 3-Year-Old?

A 3-year-old may have a fever, throw up, or can be fussy. The kids may have fever and pain while peeing and an urge to pee a lot.


How Do You Stop a Recurring UTI Permanently?

Steps to prevent recurring UTIs in kids are:

- Good bathroom habits.

- No bubble baths.

- Proper wiping.

- Regular bathroom visits.

- Wearing cotton underwear.

- Drinking enough fluids.

- Frequent diaper changes.


How to Test a Child for UTI at Home?

A UTI home test kit containing specially treated test strips is available. Holding urine in strips or dipping them in a sample of urine can check for nitrates and leukocytes produced by most UTIs. Some tests show urine pH, too.


What Is the First-Line Treatment for UTI in Children?

First-line treatment based on local antimicrobial susceptibility patterns. The medication used is cefixime, cefpodoxime, cefprozil, and cephalexin for kids with 2 to 24 months. The duration is mainly 7 to 14 days.


How Is Pediatric UTI Treated?

Medications include cefixime, extended-spectrum cephalosporins, TMP-SMX, amoxicillin-clavulanate, and sometimes quinolones are used to treat pediatric UTI. Liberal fluid intake is recommended to treat UTI.

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Dr. Veerabhadrudu Kuncham
Dr. Veerabhadrudu Kuncham



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