Urinary Tract Infection Management in Children

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  • Urinary tract infection (UTI) is the infection of the urinary system (kidneys, ureters, bladder and urethra). It can cause symptoms of fever, abdominal pain, vomiting, painful or burning sensation during urination, frequent bathroom calls with only small amount of urine, difficulty holding urine, foul stench of urine, flank pain, back pain or even blood in the urine. If not treated immediately, UTI can have serious complications including sepsis, seizure, and kidney or bladder damage. Urinary tract infections are common in infants and children. 3~5% of girls and 1% of boys under 2 years old with unexplained fever have UTI.
  • Fever management：
    1. Fever is when armpit temperature is over 37.5ºC or anal, forehead, or temporal temperature is over 38ºC.
    2. When your child has chills, keep him/her warm by adding another blanket or elevating the thermostat temperature. Do not give him/her an ice pillow.
    3. If your child has fever but the limbs are warm, give him/her a warm bath (water temperature 26~36ºC).
    4. Encourage your child to drink plenty of water to prevent dehydration. Dry off the sweat immediately. Do not wear too many layers of clothes or use too many blankets.
    5. Fever medication (antipyretics) may be given when the child’s temperature is above 38.5℃. Repeat if necessary with at least 4 to 6 hours between the antipyretics. If your child has a history of febrile convulsion, use antipyretics at a lower temperature to help prevent convulsion.
    6. Antipyretics usually need around 30 minutes to work. You may check your child’s body temperature every hour until the fever has reduced.
    7. Take antipyretics as instructed. Do not take aspirin.
  • IV (intravenous therapy) and IV pump care：
    1. Keep the dressing and injection cannula (the small plastic tube which is inserted into the vein) clean and dry.
    2. Periodically check that the the distal extremities (far end of the limb with the injection; ie. fingers or toes) that they are warm and pink.
    3. Keep the injected limb lowered to avoid IV fluid or blood refluxing into the tubes.
    4. Do not adjust the IV rate or touch the buttons of the pump by yourself. Inform the staff if you think adjustment is needed.
    5. The IV pump has a rechargeable battery. You may remove the electric the charging cable when walking around. Please keep the cable plugged in when possible.
    6. Gently compress the injection site for 1~3 minutes with a sterile cotton ball after the cannula has been removed. Remove the cotton balls if there is no more bleeding.
    7. If any of the following conditions occur, please inform the nursing staff：
      • Pain, swelling, redness, or wetness at the injection site.
      • Painful or reddening of the skin after the cannula was removed.
      • You heard the sound of pump alarm.
      • Your child needs a shower or change the clothes.
  • Avoid putting on diapers too tightly. Change diapers at least every two hours, as urine and feces that have been sitting too long may breed bacteria which may increase the risk of urinary tract infection.
  • Older children should wear underwear with 100% cotton material. To reduce bacteria growth, underwear should also be changed when damp from water or sweat.
  • Encouraged your child to drink plenty of water. 100% juice without sugar additives such as cranberry, citrus juice, or guava juice are also recommended.
  • Do not hold the urge of urination. Remind your child to the go to the toilet between play time. Tell your child to not rush during voiding to allow complete emptying of the bladder.
  • Cleaning up and hygiene：
    1. Girls should wipe from front to back (ie. from the urethra towards the anus)
    2. Boys should gently push the foreskin down to wash the glans everyday.
    3. Take showers instead of baths.
  • Call your pediatrician or go to the emergency department if there are following symptoms：
    1. Fever over 38 ℃ with poor appetite (anorexia) or decreased activity.
    2. Voiding difficulty or pain causing your child to cry or scream.
    3. Decreased urine amount or foul smelling urine.
    4. Purulent secretions on diapers.
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