How to treat E.coli urine infection in a small kid?

Hello,

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She is having a urinary tract infection. Earlier, you mentioned it was E.coli. What was the sensitivity pattern for drugs?

Current reports show Klebsiella (sensitive to Amikacin) (attachment removed to protect patient identity).

You have not mentioned about the symptoms. Is there any fever, pain in abdomen, vomiting, burning, painful micturition, or constipation? I would recommend you to get DMSA (dimercaptosuccinic acid scan)done.

It will help us to see the anatomical changes in the kidney which are often not picked up by ultrasound. If it is normal, then nothing to worry only follow up will be done. If abnormal, then MCU (Micturating cysto-urethrogram) would be the next step, which we will talk in detail once the DMSA is done.

Kindly document the blood pressure of the child also with appropriate cuff size at your nearby hospital. Have the symptoms resolved? Is she showing signs of improvement?

In that case, please continue giving injection Amikacin for 10 days total.

If no improvement and accepting orally, then give plenty of water. Maintain good hygiene or frequent hand washing to prevent further infections. Give syrup Amoxyclav (Amoxicillin and Clavulanic acid) (5/457) 3 ml twice daily for 10 days, syrup Paracetamol (5/250) 3.5 ml when required in case of fever or pain, and Darolac sachets one sachet twice a day for five days.

If symptoms are persisting and the child is toxic with high fever, pain in abdomen, vomiting, and not accepting orally then we will switch to another injectable. Kindly attach E.coli culture and sensitivity reports.

Hello,

Welcome back to icliniq.com.

Good to hear that she is doing well now. You have not attached the E.coli culture sensitivity reports as it would have helped me out judicially in guiding you with antibiotics.

So according to the latest reports of Klebsiella culture and sensitivity, you can start and continue treatment at home. Stop injection Amikacin.

As mentioned earlier, start with syrup Amoxclav as per the sensitivity reports for 10 days with syrup PCM as when required, and Daroloac sachet for five days. Give plenty of fluids it will help both in urine infection and constipation.

If there is a known history of constipation, then we can start her on medications. If just a single episode of the passage of hard stool as you have mentioned and not bothersome then nothing to be done. Give plenty of water and increase the intake of roughage (more salads).