UTI (recurrent) prophylaxis
Note: antibiotic prophylaxis to prevent recurrent UTIs is not routinely recommended after the first UTI.
See UTI pathway (on Children’s Services web-site, under Renal)
Preferred
trimethoprim 2mg/kg (max 100mg) po ON
Alternative (if able to swallow tablets) *
nitrofurantoin 1mg/kg (max 100mg) po ON
Caution should be used if children are on long term prophylactic nitrofurantoin for UTI due to risk of hepatic and pulmonary adverse drug reaction (see MHRA Drug Safety Update). Use with caution in patients with pulmonary disease or hepatic dysfunction.
If treated with nitrofurantoin
- Regular checks of liver function should be undertaken, and,
- If under 6 years of age: review for pulmonary symptoms
- If 6 years and over: consider referral for lung function testing if patient has unexplained respiratory symptoms.
*if unable to swallow tablets and nitrofurantoin is the only therapeutic option, please contact paeds ID or a paeds pharmacist to discuss the use of suspension (non-formulary) or alternative options.
Methenamine may be a suitable prophylactic agent in some cases. Discuss with Paeds ID.