Spectrum: Local Antimicrobial Stewardship, for IWK Health Centre

Prophylaxis for Prevention of Recurrent UTI

Note

Antibiotic resistance is a major concern when children are given chronic antibiotic prophylaxis.

All patients with high grade reflux or documented recurrent urinary tract infections should be referred to urology.

Antibiotic prophylaxis is recommended by urology or nephrology in specific clinical situations and for specific time periods.

In addition to investigating any urologic cause, diagnosis and management of bowel and bladder dysfunction remains a cornerstone of prevention.

Empiric Antimicrobials

Cephalexin - Less than or equal to 6 weeks of age
6.25 mg/kg/dose PO BID

Cephalexin- Greater than 6 weeks of age
12.5 mg/kg/dose PO daily
Maximum: 500 mg/dose

OR

Greater than 1 month only
Nitrofurantoin 1-2 mg/kg/dose PO daily

OR

Greater than 1 month only
Dosing is based on the trimethoprim component:
Co-trimoxazole 2 mg/kg/dose PO daily