Patient: Hi my daughter is 5 she recently had 5 days on amoxislav against UTI her symptoms seemed to get better but came back after less than a week. when the tests were done she had not rotates and leukocyte esterase positive. but they didn’t take the urine culture. her initial symptoms were occasional pain, frequent urination. there was no fever. now it’s the same. we are on holiday now and doctor prescribed nitrofurantoin but did no tests as now it’s Friday so need to wait till Monday now. should I give it to my daughter? why didn’t the first antibiotic help ? I’m worried about using too much antibiotics and resistance to them. also what tests for you recommend for Monday ? thank you !!!!!
Doctor: Hi,Thanks for writing in.It will help to know if any urine culture was done initially and whether the bacteria cul ture report documented sensitivity to amoxiclav.It is possible that the bacteria responded partially to amoxiclav or there was a mixed infection which is causing persisting urine infection.Nitrofurantoin is a urine infection specific antibiotic and can be given in children in recommended doses. This particular antibiotic gets concentrated in the urinary tract and therefore is good in the treatment of urine infections.Since you are on a holiday, you can continue nitrofurantoin on the recommendation of your doctor. If symptoms persist even after treatment with nitrofurantoin then a urine culture and sensitivity test is recommended and doing an ultrasound scan abdomen and pelvis might be required.Please have your daughter drink adequate water and fluids.Hope your query is answered.Please do write back if you have any doubts.Regards,
Comments / Follow Ups
Patient: thank you for the answer! we will try nitrofurantoin. no urine culture was taken initially and no sensitivity of bacteria tested either. also I forgot to ask -after amoxislav she had candida infection in the vaginal area. we used antifungal cream for about 1 week and cleared. if it starts again shall we just use as required? we were prescribed canesten cream. I also give probiotic.
Thanks for writing back.
I guess nitrofurantoin will work and cure her urinary infection completely.
Candida is a fungal infection as you are aware and mild fungal infection can be treated with cream. It is important that you please discuss genital hygiene with your daughter so that she tells you if it starts itching again then you can start treatment with antifungal cream. Genital hygiene should be explained to the child so that further urinary and fungal infections can be prevented.
Probiotics will keep her bowel function normal.