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Recurrent UTI
June 2003

Q. My 10-year-old daughter has recurrent urinary tract infections (UTIs) over a 3-year time. They have done ultra sounds, blood tests and void tests. They have all come up negative. She was put on Macrodantin, but every time they try to take her off the UTI comes back. I have been told she will grow out of this. She was first on Macrodantin 6 months then 1 year. I am concerned about why this might be happening and also the long-term affect of Macrodantin. When she gets a UTI, her symptoms are heavy blood in urine, fever, pain in lower abdomen. Can you help?

A. Urinary tract infection is a common clinical problem, more so in teens and adults. When UTI occurs in a child, a thorough investigation is warranted to determine if a correctable cause can be found. These tests evaluate the anatomy and function of the kidneys and bladder and usually involve lab tests and imaging studies as you have described.

Abnormalities of anatomy may need surgical correction, such as an abnormal connection of the ureter to the bladder. Despite such testing, in many cases no specific cause can be found. It is thought that infection-fighting mechanisms in the bladder may be deficient but this possibility is still being researched. Treatment is usually to attempt prevention of infection with low dose ongoing antibiotic treatment, hoping to avoid any permanent damage to the kidneys.

http://www.niddk.nih.gov/health/urolog/pubs/utichild/utichild.htm

http://www.pediatriconcall.com/forpatients/CommonChild/urinary_tractinfection.asp

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