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What precautions should we take for our son suffering from UTI?

Q: My son, aged 10 years, has only one kidney. After doing some tests it was found that there was some reflux, urine was going into the kidney. Since then, he has been using Oflin 100 mg (one tablet a day) regularly. Yesterday we got the urine test done again and the pus cells were 5-6. He takes a lot of water daily. Earlier he did not go to toilet during nights. But, for the last 1-2 weeks he has been going to toilet during nights also. Recently doctors told me that we should be very careful about his health. He is very active. My question is: what are the precautions we need to take and how can we know that he is going to be fine?

A:You are advised to get the kidney function tests as well as look for 24 hours urinary protein excretion. In case they are normal there may not be much reason to worry and the main important thing would be to prevent urinary tract infections through long term low dose antibiotic therapy. All measures should be taken to prevent infections and eradicate it. However, if the bacteria were sensitive to cotrimoxazole or Nitrofurantoin, it may be preferable to give either of the two in place of ofloxacin which he is on at present in view of the chances of early appearance of resistance with the latter. The grading of reflux is very important in deciding the future management. If the reflux is of low grade, surgery would not be required and only prevention of urinary tract infection has to be ensured. He would require periodic assessment of kidney function. A baseline DTPA scan repeated after about a years interval can be a useful tool. Additionally blood investigations including kidney function tests should be done and even if normal should be repeated at least once a year. He should have his routine exam of urine done at least once a month for he time being and once the infection is effectively under control the interval may be increased to 3 months.

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