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NICE guidelines for imaging studies in children with UTI adequate only in boys under the age of 6 months.
MedLine Citation:
PMID:  23314790     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: The purpose of this study was to evaluate the applicability of the National Institute for Health and Clinical Excellence (NICE) guidelines for imaging studies in children under the age of three with first urinary tract infection (UTI). METHODS: In our cohort of 112 patients, we gathered data regarding the occurrence of indications for ultrasonography (US) and voiding cystourethrography (VCUG) according to the NICE guidelines, dimercaptosuccinic acid (DMSA) scintigraphy examinations, UTI recurrence, antimicrobial prophylaxis (AMP), anti-reflux procedures, and other urological procedures. RESULTS: If the NICE guidelines had been applied, 13 of the 25 patients (52 %) with vesicoureteral reflux (VUR), including 6 of the 12 patients (50 %) with dilating VUR and 3 of the 4 patients who underwent endoscopic anti-reflux treatment, would have been missed, and a negative VCUG would have been avoided in 25 of the 42 patients (60 %) with no VUR. None of the missed diagnoses occurred in the younger boys' group. CONCLUSION: Based on these preliminary analyses, we feel that the NICE guidelines for imaging studies in children under 3 years old with UTI may be applicable to clinical use only in boys under 6 months of age. For other patients the guidelines were unsuccessful.
Authors:
Marko Tapani Ristola; Timo Hurme
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-13
Journal Detail:
Title:  Pediatric surgery international     Volume:  -     ISSN:  1437-9813     ISO Abbreviation:  Pediatr. Surg. Int.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8609169     Medline TA:  Pediatr Surg Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Turku University Hospital, Turku, Finland, mtrist@utu.fi.
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