AboutDr Graham Smith Expertise I am accredited in general paediatrics and paediatric nephrology and and am happy to answer questions on both topics.
It is not possible or safe to assess acutely sick children through this medium. Such children should be taken to their own doctor, where a full history can be taken and an examination carried out.
Experience I have been a consultant paediatrician and paediatric nephrologist for 13 years. I have been involved in paediatrics for 22 years.
Organizations Royal College of Paediatrics and Child Health
British Association for Paediatric Nephrology
European Society for Paediatric Nephrology
International Pediatric Nephrology Association
Publications Archives of Disease in Childhood
British Medical Journal
Pediatric Nephrology
Current Paediatrics
Nephrology, Dialysis and Transplantation
Nephrology and Urology
Education/Credentials MA (Cantab)
MB BS (London)
MRCP
FRCPCH
Question My daughter is 2 and 1/2 years old. She just had her first UTI. The doctor wants us to see a pediatric urologist and have a "reflux study" done. I don't understand why she is insisting on doing this study and also giving preventative antibiotics in the meantime when this is her first UTI ever. Can you shed any light on this? Thank you.
Answer The policy in the UK is less invasive and has been made even less so by a recent publication by a body called NICE.
In a case such as this, with an uncomplictaed UTI (although you do not say how unwell she was), I would just get an ultrasound scan and if this was OK not do anything else, other than give advice to look out for further UTIs and have them treated promptly.
The problem is that there is wide variation in management strategies, particularly with respect to investigation, due to lack of good evidence.
There is hoever evidence now indictaing that antibiotic prophylaxis is not generally helpful.
If I was going to see anyone, it would be a paediatric nephrologist rather than urologist.
