Management of paediatric recurrent urinary tract infections and challenges in special patient populations

BACKGROUND: Urinary tract infections (UTIs) affect up to 8.4% of girls and 1.7% of boys within their first six years of life. The rate of recurrence is as high as 30%, with the effects carrying long-term morbidity. Concomitant pathology such as vesicoureteric reflux (VUR) or bowel and bladder dysfunction (BBD) can pose further diagnostic and management challenges in the primary care setting. OBJECTIVE: The aim of this article is to discuss the approach to diagnosis and management of recurrence and strategies to prevent it, with additional information regarding patients with VUR and BBD. DISCUSSION: Management of recurrent UTIs requires family-centred care, with conservative, pharmacological and surgical options effective across different patient groups. In situations that exceed the capacity of local services, referral to paediatric subspecialties should be considered to assist in further investigation of recurrent cystitis-like symptoms.