How do we manage uro infections?

- When a child has Orchi epididymitis, we should investigate for any lower urinary tract anomalies such as obstruction, posterior urethral valve, hyperactive bladder, ectopic ureter… - In case of an infection: first, we treat the acute infectious phase and then investigate the cause of the infection. - The most effective treatment for testicular issues is ciprofloxacin BUT it’s contraindicated for children - Ciprofloxacin works on DNA gyrase (an enzyme in cartilage) à problems in growth. This is why it’s contraindicated in children. What do we give instead? 3rd generation cephalosporin (good penetration) - The choice of antibiotics (in UTIs) depends on two factors: concentration in urine and penetration into tissue. - For testes, best treatment is 3rd gen cephalosporin. For Orchi epididymitis the duration of treatment is normally 10-15 days. After treating the infection, we search for the cause.