Expert: David Olson, MD - 6/30/2009

Question
My question is this:
If you saw a 2 and half year old female with her first UTI, would you immediately suggest a "reflux study" be done?  That is what my child's practice says, and I don't understand why one UTI means preventative antibiotics and a pediatric urologist for a reflux study??  Seems overly proactive to me.  Can you help me understand this?

Answer
Hi, Amber,

The older a child becomes with the first infection, the less likely the testing will find reflux.  I personally would only treat a non-febrile UTI in this age group, with this being the first infection, and then document a cure by a normal followup urine.  I think the approach you are suggesting for a first infection (without a fever) in a 2 1/2 year old girl is overly aggressive.  There is not a great consensus of opinion about this, however.

Good luck, Dr. Olson