Pyelonephritis is a complex inflammatory process of the kidneys. This disease can occur at absolutely any age. It is dangerous because it develops very quickly and therefore requires urgent medical care.
Pyelonephritis in newborns poses a threat to life, since it is not always possible to detect it in the initial stages. Complications can affect other organs, so the child often ends up in the intensive care unit.
Feature of the disease
The kidneys play a very important role in the human body. They are responsible for the elimination of toxic substances and decomposition products along with urine.
This body regulates the salt and water balance in the body, is responsible for the production of vitamin D, and also highlights some of the active components responsible for hemoglobin levels and pressure regulation. The proper functioning of other organs in a child largely depends on the proper functioning of the kidneys. Therefore, it is important to recognize pyelonephritis in newborns to prevent the development of complications.
During the course of the disease, not only the kidneys themselves but also the pelvis become inflamed. At the same time there is a serious violation of urine outflow. This has very serious consequences and various kinds of complications.
According to the classification, pyelonephritis in newborns can be primary and secondary. The primary form of the disease occurs without any prerequisites and urological diseases. The infection process begins to develop in an initially healthy organ. The secondary form of the disease is characterized by the fact that the pathology is formed in the presence of inflammation of the urinary tract. This is the most common type of disease.
According to the stage of flow, pyelonephritis in a newborn can be infiltrative and sclerotic, and in localization it can be unilateral and bilateral. Initially, the child has an acute form of the disease, and at the same time the symptoms are quite pronounced. If you do not conduct a comprehensive and timely treatment, then it goes into chronic pyelonephritis.
The disease can occur in a latent form, in which case urinary syndrome is only slightly manifested. This is the most insidious type of disease, since it is almost impossible to detect it in a timely manner.
The causes of pyelonephritis in newborns are mainly associated with the penetration of infectious agents into the kidneys. Often the disease is triggered by Escherichia coli, but many other bacteria, in particular, enterococci, Klebsiella, protea, can act as the causative agent. They enter the kidneys through the circulatory system, lymph or from the urethra.
Most often, kidney pyelonephritis in newborns develops due to the penetration of bacteria in an ascending way. They fall from the perineum and rectum. Improper hygiene measures, as well as a drastic weakening of the immune system, contribute to bacteria drift. If there are predisposing factors, the infection rises into the bladder and then enters the kidneys.
The causes of pyelonephritis in a newborn boy may be due to the presence of other diseases. In this case, the source of infection are the affected bronchi, tonsils, umbilical process, pharynx. Against the background of a weakened immune system, bacteria enter the bloodstream and then spread to the kidneys.
Very rarely, the infection is spread through the lymphogenous way. This occurs when the urinary tract mucosa is damaged and bacteria spread from the rectum. There are several causes of pyelonephritis in newborns, in particular such as:
- congenital abnormalities of the urinary system,
- pregnancy pathology,
- violation of urine,
- prolonged hypothermia
- the presence of inflammatory diseases
- feeding with artificial mixtures
- the presence of worms,
- some concomitant diseases.
In case of advanced acute inflammation, chronic pyelonephritis occurs. The disease develops in the absence of a full-fledged treatment or administration of unsuccessful antibacterial drugs. Sometimes chronicity can be triggered by some congenital abnormalities of the immune system.
Symptoms of the disease
Symptoms of pyelonephritis in newborns are quite specific. Infants cannot indicate pain and describe their feelings. Parents are aware of the ongoing pathology only by indirect symptoms.
The most characteristic sign of pyelonephritis is a rise in temperature to 38-39 degrees. In a child of 3 months, the fever is more pronounced, and the temperature can rise to 40 degrees. The course of the disease without fever is characteristic of premature babies.
In addition, the baby shows great anxiety. The skin of a newborn gets a painful pale tint. The kid refuses to consume food and begins to lose weight dramatically. Nausea and diarrhea can join the clinical picture.
In some cases, parents with pyelonephritis in a newborn boy note a violation of urination. The jet becomes intermittent and weak.
The disease is also characterized by a change in the quality of urine. A cloudy precipitate forms in it. Urine can also contain minor blood impurities and have a rather unpleasant odor. The exacerbation of the chronic form of pyelonephritis has exactly the same symptoms as the acute course of the disease. The period of remission is characterized by the complete absence of signs of the disease. Sometimes this pathology is accompanied by a constant slight increase in temperature.
In order to diagnose "pyelonephritis" in newborns, when the first signs of disease progression appear, parents should contact a pediatrician who, after an examination, sends to a nephrologist. If the assumptions regarding the presence of pyelonephritis are confirmed, the nephrologist will give direction to a general and biochemical blood test, as well as a urine test.
In some cases, ultrasound diagnostics of the urinary system organs, excretory urography, radiography, and tomography may be additionally prescribed. With an especially severe course of the disease, a special needle is inserted into the kidney and a small amount of tissue is subsequently collected for morphological examination.
Pyelonephritis is a frequent disease of babies. Pathology occurs 3-5 times more often in female babies. This feature is associated with the structure of the urethra. The urethra of girls is much wider and shorter than that of boys, which creates favorable conditions for the migration of bacteria upwards.
In newborns, pyelonephritis occurs with a frequency of 0.3 to 3%. The highest peak of incidence falls on the age of 3-6 months, when the baby gets supplements. Also in this period there is a decrease in the number of protective maternal antibodies in the blood.
Among all hospital admissions of one-year-old children with an increase in body temperature, the proportion of pathology accounts for about 10%. About 3% of cases of the disease ends with chronic inflammation and persistent relapses at an older age.
The cause of acute pyelonephritis is infection of the pathogen in the kidney. Most often, the disease is caused by Escherichia coli, but other bacteria such as Klebsiella, enterococci, protea can act as an inflammatory agent. Pathogens enter the kidneys through the blood, lymph or ascending pathways from the urethra.
Most often the disease develops due to the migration of the pathogen in an ascending way. The reservoir of bacteria - the rectum and perineum. Improper hygiene measures, weakening of immunity contribute to the importation of microorganisms into the urethra. In the presence of predisposing factors, infectious agents rise into the bladder, and then into the kidneys.
Less commonly, neonatal pyelonephritis develops with hematogenous migration. The reservoir of bacteria are the infected organs - the tonsils, bronchi, pharynx, umbilical process. Against the background of weakened immunity, microorganisms enter the blood and spread to the kidneys.
Very rarely, the disease is caused by the lymphogenous way. It is carried out in case of damage to the mucous membrane of the urinary tract and the migration of bacteria from the rectal area.
Chronic pyelonephritis - a consequence of neglected acute inflammation. The disease occurs in the absence of treatment or administration of ineffective antibacterial agents. Sometimes the chronization process is caused by congenital pathologies of the immune system.
There are nine predisposing risk factors for pyelonephritis:
- Congenital abnormalities of the urinary system.
- Reflux disease of the urinary tract.
- Pathology of pregnancy, prematurity, lack of weight at birth.
- Pathology of the composition of urine in diabetes and other diseases.
- Prolonged hypothermia, contributing to muscle spasm and circulatory disorders.
- The presence of helminthic invasion of the lower gastrointestinal tract.
- The presence of inflammatory diseases of the external genital organs.
- Food artificial mixtures.
- The presence of some associated diseases - dystrophy, rickets, atopic dermatitis.
Pyelonephritis in children: symptoms and treatment methods
Symptoms of the disease have no specificity. Infants cannot describe and indicate pain syndrome. Parents are aware of a violation of well-being due to indirect symptoms.
The most characteristic sign of acute pyelonephritis is an increase in body temperature up to 38-39 and higher. In a 3 month old baby, fever often reaches 40 degrees Celsius. The course of the disease without a rise in body temperature is characteristic of very premature babies.
Parents can note the changing nature of the baby. He becomes restless, lethargic, constantly crying. The skin gets a pale shade. The baby refuses to eat, loses weight. Also, vomiting and diarrhea are often associated with the clinical picture.
Sometimes parents can notice changes in the process of urination. During it, the child becomes restless, he strains and blushes. The jet becomes weak and intermittent. Sometimes there is increased urination.
The disease is characterized by a change in the quality of the urine. A cloudy precipitate appears in it. Urine may contain a small amount of blood, have an unpleasant smell.
The exacerbation of chronic pyelonephritis has the above clinical picture. The remission period is characterized by the absence of signs of the disease. Sometimes pathology is accompanied by a constant increase in body temperature to 37-38 degrees.
The pediatrician deals with the diagnosis and treatment of the disease. In some hospitals, pediatric nephrologists specialize in the kidneys.
At the first admission, the doctor interviews the parents about the condition of the child. Then the specialist conducts a clinical examination. Particular attention is paid to measuring body temperature, skin color, the presence or absence of edema. The doctor measures blood pressure to rule out other pathologies of the kidneys.
Objective symptom of kidney damage is pain when tapping the waist. The child becomes restless, begins to cry. A similar reaction occurs with pressure in the region of the junction of the 12th rib and the first lumbar vertebra.
Then the baby is assigned laboratory tests. They allow you to assess the presence of the inflammatory process, its intensity and the involvement of organs.
In the clinical analysis of blood, an increase in the number of leukocytes is observed due to an increase in the stab forms. Also, experts say ESR more than 10-20 millimeters per hour.
In the biochemical analysis of blood, an increase in the amount of creatinine and urea, markers of renal damage, is found. Laboratory assistants note high levels of C-reactive protein and procalcitonin.
In the clinical general analysis of urine, an increase in the number of leukocytes is observed. Cylinders also appear in urine, and sometimes a small number of red blood cells. Perhaps the development of weak proteinuria - loss of protein in the urine.
Bacterial urine culture is used as a special research method. The material is collected before the start of antibiotics. The study allows to sow a certain strain of the pathogen and to select the most effective drug for the treatment of pyelonephritis.
The doctor may prescribe a urine test according to Nechiporenko. It shows a strong increase in the number of leukocytes. Sometimes children are shown the study of urine in Zimnitsky. The analysis reveals a violation of the concentration ability of the kidneys.
For differential diagnosis with other pathologies of the kidneys shown instrumental methods of research. The most common of these is ultrasound scanning. Less commonly performed urography, computed and magnetic resonance imaging.
The main principle of treatment of pyelonephritis in young children is the appointment of an effective and rational antibiotic therapy. Before obtaining the results of BAC urine culture, doctors prescribe drugs with a wide spectrum of action.
The most commonly used drugs in the pediatric practice are those from the penicillin group. These include Amoxicillin, Amoxiclav. Also, young children are allowed to take cephalosporins - Cefuroxime, Ceftriaxone.
With the ineffectiveness of these groups of drugs or obtaining unusual results of BAC-urine culture, other antibiotics are prescribed. Babies are prescribed carbapenems, macrolides. In severe cases, in the presence of highly resistant bacteria, broad-spectrum antibiotics (Ceftriaxone), aminoglycosides and fluoroquinolones are indicated.
In the treatment of chronic pyelonephritis, similar antibiotics are used. However, the duration of therapy may be increased to 14-21 days. After completing the course, delivery of urine to the crop is obligatory.
For symptomatic therapy using drugs that improve the flow of urine. The most popular of them is Canephron. The drug contributes to the discharge of infected urine, the death of pathogenic bacteria.
Also, babies are shown vitamin A, D, C and group B. After a course of antibiotics, the use of probiotics that restore the intestinal microflora - Bifidum is recommended.
The transition of the infectious process to the chronic form is dangerous to the health of the baby. Constant exacerbations worsen the quality of life. A long course of pyelonephritis leads to unpleasant consequences — replacement of normal kidney tissue with connective tissue — nephrosclerosis.
Nephrosclerosis - A dangerous condition that causes chronic renal failure. Pathology violates the filtration function of the body, over time, the patient is forced to switch to hemodialysis. That is why parents should monitor the baby’s health and follow all treatment rules.
After suffering acute pyelonephritis or a cured chronic form of the disease, dispensary registration is shown every six months for five years. At each examination, the doctor assesses the condition of the child, examines the results of a general urine analysis. If there is a relapse, the baby should be visited by the doctor every three months.
The prevention of pyelonephritis is based on hygiene. Parents should ensure frequent and proper washing of the genitals of the infant. You should also avoid hypothermia, thirst and prevent prolonged infections of other organs.
General information about the disease
This disease, which is inflammatory in nature, is caused by infectious microorganisms. Infants are very susceptible to the development of this pathology.
It should be noted that in girls, pyelonephritis is much more common than in boys. It manifests itself at the age of 5-6 months, when the child, in addition to breast milk, consumes various foods.
In pyelonephritis, the pelvis, kidney cups and urethra are damaged.
Doctors note the following trend: the more often a child has an infectious disease, the more often it has problems with the urinary system.
Types and forms
- With primary conditionally pathogenic and intestinal microflora predominate in the form of the disease in the child’s body. Due to frequent colds, a violation of the bowels (frequent diarrhea or constipation) develops. This form is manifested in the presence of cocci in the body, skin diseases, purulent tonsillitis.
- Secondary arises due to congenital pathological processes of the urinary system. These may be abnormalities in the development of the kidneys, urethra, or urea. The development of the disease begins with a violation of the proper outflow of urine, as a result of which it is not removed from the body, but accumulates in the kidneys. Very often, this form of pyelonephritis occurs in children with underdeveloped kidneys.
It is important to identify the beginning of the development of the disease in time, only in this case it is possible to conduct an effective treatment. There is also a division into acute and chronic forms.
Chronic pyelonephritis can occur in the form of a relapse (with persistent symptoms) or latent (absence of any symptoms). It is worth noting that the latent form is very rare.
Stages of flow
For the acute form of pyelonephritis are characterized by such signs:
- high body temperature,
- frequent regurgitation and emetic processes,
- loss of appetite, weak breast sucking,
- pale skin,
- blue areas around the mouth, lips and skin above the upper lip,
- weight loss
- severe dehydration (characterized by dry skin).
In addition, pyelonephritis is accompanied by severe pain in the abdomen, but the baby can not say about it. As a result, the baby becomes irritable, capricious, does not sleep well.
Another sign is the change in color and odor of urine (this can be detected if the child is without a diaper).
In the case of the chronic form, the symptoms then aggravate, then subside. It is very important to diagnose this disease in its early stages in order to prevent many complications.
If you have one of the unpleasant symptoms, you should first turn to the local pediatrician, the pediatric urologist will be treating the child. Mandatory analyzes are:
- Blood donation on general and biochemical parameters. In case of pyelonephritis, ESR and leukocytes are overestimated, the amount of hemoglobin and erythrocyte cells will be negligible.
- Analysis of urine on general and biochemical parameters, the method according to Nechiporenko. In pyelonephritis, the number of leukocytes is very high.
- In the presence of infection is carried out bacteriological seeding urine in order to identify the sensitivity of the pathogen to a particular type of antibiotics.
- Required ultrasound procedure organs of the urinary system.
As additional tests, doctors may prescribe a radiopaque diagnosis to identify vesicoureteral reflux or other organ pathologies. There is a frequency and nature of urination, controlled diuresis.
In the acute form, the baby is prescribed medications that reduce body temperature and pain symptoms (Ibuprofen, Panadol baby).
Often babies are placed in stationary conditions until the state stabilizes.
In order to reduce the burden on the kidneys, it will be advisable to stick to a diet.
In this case, the baby should consume half the more fluid characteristic of his age.
Be sure to prescribe a course of antibiotics. To do this, first conduct a test for the resistance of the pathogen to different drugs. Thus, the most effective is selected, the duration and the rate are prescribed by the doctor individually for each patient.
as a rule, such treatment lasts a month if the antibiotic is replaced every week (this is done so that the pathogen does not develop resistance to the components of the drug). I also prescribe drugs for urinary tract disinfection.
In chronic pyelonephritis, treatment is much more complicated due to the difficulty of identifying the root cause. It is also carried out in stationary conditions, sometimes they can perform a surgical operation. Be sure to prescribe antibiotics, uroseptikov and herbal remedies during remission.
To restore the intestinal microflora during antibiotic treatment, probiotics such as Linex or Acipol are used. They stimulate the immune system, take vitamins and antioxidants.
Many parents prefer to independently treat their children at home. However, in the case of infants, it is very dangerous and is fraught with negative consequences.
When diagnosing pyelonephritis, it is advisable for the child, in parallel with the main treatment methods, to take decoctions or infusions of medicinal plants that have antibacterial, anti-inflammatory and anesthetic effects (bearberry, chamomile, St. John's wort, calendula, etc.).
To eat more foods that have diuretic properties (watermelon, prunes, lingonberries, etc.).
On their application is better to consult a doctor. It is important to remember that improper treatment of pyelonephritis in infancy leads to complications in the older.
Prevention and prognosis
In general, the prognosis after treatment is positive. With the acute form of the disease, recovery occurs on average in a month.
In the case of chronic pyelonephritis, the child is on a permanent account with a doctor and is periodically treated.
To prevent disease, you must comply with these requirements:
- ensure that the child does not become cold,
- to follow the rules of personal hygiene to rinse after each emptying,
- time to treat colds and infectious diseases,
- improve immunity
- follow the baby’s food
- Use only baby water for drinking and cooking.
Observing these simple rules can protect your child from such a serious illness as pyelonephritis.
Feature of treatment
To eliminate the symptoms and causes of pyelonephritis in newborns, treatment must necessarily be comprehensive. When the first signs of illness appear, the baby is hospitalized with the mother to a specialized hospital where diuresis and the general condition of the baby are traced. Based on this, therapy is selected and adjusted.
Be sure to require specialized drug treatment. In particular, drugs such as are prescribed:
- herbal remedies.
Treatment in the hospital continues for 3-4 weeks. Preparations are strictly selected by the urologist or nephrologist, preferring the most optimal combinations. Independently it is strictly forbidden to treat pyelonephritis in newborns, as many drugs are strictly contraindicated in infants or are not sufficiently effective when they are taken at the same time.
The basic principle of the treatment of pyelonephritis in newborns is the appointment of effective and rational antibiotic therapy. Before obtaining diagnostic results, doctors prescribe a broad-spectrum drugs. The most commonly used antibiotics from the group of penicillins. These include "Amoxiclav", "Amoxicillin". In addition, infants are also allowed to take cephalosporins, in particular, such as Ceftriaxone, Cefuroxime.
The duration of therapy is 7-10 days. It is strictly forbidden to prematurely discontinue the use of drugs, as this leads to a steady growth of pathogenic microflora.
With the ineffectiveness of all these groups of drugs, other antibacterial agents may also be prescribed. Macrolides and carbapenems are prescribed to newborns. With a particularly severe course of the disease and the presence of highly resistant pathogens, broad-spectrum antibiotics, fluoroquinolones, aminoglycosides may be indicated.
For symptomatic therapy used drugs, normalizing the flow of urine. Canephron is considered the most popular. Such a drug contributes to a more rapid discharge of infected urine and the death of bacteria. Children are shown taking vitamins. After a course of antibiotic therapy, the use of probiotics is shown, which help restore the normal intestinal microflora.
If the fungal infection of the kidneys has been proven, then antifungal agents are prescribed in tablet form. During their reception, it is necessary to control the therapy with the help of urography and other techniques. After a course of antibiotic therapy, uroantiseptics are prescribed, as this helps prevent the disease from flowing into the chronic stage. These antimicrobial drugs help eliminate the inflammatory process.
To eliminate puffiness and inflammation, antihistamines are prescribed. In addition, they help to stop the signs of allergy in the event of a reaction to the antibacterial agents used. In rare cases, with serious kidney damage, surgical treatment may be prescribed.
Compliance with the regime
Treatment of pyelonephritis mainly takes place in the hospital and only in some cases at home. Therefore, for the period of therapy, parents must observe a certain regimen.
It is important in the process of treatment to carry out exclusively natural breastfeeding. Also of great importance is the maintenance of thorough hygiene of the newborn.
The transfer of the infectious process to the chronic stage is a particular danger to the health of the child, and constant exacerbations significantly worsen the quality of life. The prolonged course of pyelonephritis leads to various complications. After suffering an acute form of the disease, mandatory dispensary registration is shown once every 6 months for 5 years.
In the first month of life, the baby’s kidney size is about 5 cm. Bacteria very quickly infect this baby’s organ. That is why pyelonephritis progresses very quickly, significantly increasing the risk of complications. This is very dangerous, as it threatens to damage other organs. The effects of pyelonephritis on a newborn boy or girl can be as follows:
- the transition from acute to chronic
- arterial hypertension,
- necrosis of the canalicular system
- multiple kidney abscesses.
As a result of increased stress on the heart and pressure, hypertension begins to develop. Complications are very serious, which is why, in order to prevent them, you need to consult a pediatrician in time.
The occurrence of pyelonephritis and its complications is quite possible to prevent, the most important thing is to comply with certain preventive measures, in particular:
- carefully monitor the hygiene of the newborn,
- wear diapers before going to bed or walking
- women during breastfeeding need to follow a diet
- undergo periodic routine checkups,
- in a cool time, warm your baby
- maintain immunity
- when identifying the first signs of the course of the disease immediately contact a pediatrician.
After the previously transferred pyelonephritis, the child should be registered with the urologist. Also consultations and inspections of the nephrologist will be required. Care should be taken when administering vaccination. With the occurrence of acute pyelonephritis in a child, vaccination until the age of one year can be postponed until complete normalization of well-being.
If the child has already had the disease, then it is necessary to take preventive measures so that relapses do not recur. To prevent the development of chronic pyelonephritis, it is imperative:
- make sure that bladder emptying is frequent and timely,
- control that the baby is well enough sleep, drink enough liquid, take vitamins,
- organize frequent walks in the fresh air,
- periodically do a biochemical blood test.
Pyelonephritis is a very serious disease, especially in infants. With the wrong or late treatment of the acute form, the disease can turn into a chronic stage, which is fraught with dangerous complications and frequent relapses.
Symptoms of pyelonephritis in infants
The course of the disease in young children has some differences and depends on the age of the child.
So, in infants, the following symptoms will be noted:
The rise in body temperature to high values, fever will last from two days or more,
Complete rejection of breast sucking,
Urine has an unpleasant odor,
Intestinal disorders with a predominance of loose stools,
During urination, the newborn may show anxiety, which is expressed in crying,
The child may show increased drowsiness.
Urination occurs in small portions,
The younger the child is, the faster he will lose weight, especially against the background of high temperature.
During the neonatal period, pathogenic bacteria that provoke pyelonephritis circulate in the child’s blood, so the symptoms of the disease are not specific to this inflammation:
Body temperature can drop to critically low values, or reach high elevations, causing a feverish state,
Often there is yellowing of the skin,
The baby refuses to suck the breast,
There are repeated regurgitations and vomiting,
In newborn male babies, hyponatremia and hyperkalemia are detected, although the development of these conditions is possible in girls,
The child is delayed in development.
Causes of pyelonephritis in infants
In most cases in the neonatal period, the cause of the development of the disease is the ingress of bacteria into the baby’s blood. By circulating in the bloodstream, they hematogenically reach the kidneys and cause inflammation of their tissues and systems. Therefore, almost any microbe can lead to the development of the disease in the newborn.
As for infants, they are more characteristic of an upward pathway of infection, when pathogens enter the kidneys from the bladder. In most cases, pyelonephritis in infants is provoked by E. coli (read also: Causes and symptoms of E. coli), although it can occur in the kidney tissues of clesibella, enterococcus bacteria, less often - staphylococci, streptococci, viruses, fungi. Kidney damage by microbial associations is not excluded.
The following factors contribute to the development of the disease:
Purulent omphalitis of newborns,
Pustular lesions of the skin,
Vulvitis, vulvovaginitis, cystitis, balanoposthitis,
Inadequate and inadequate care for the child, non-observance of the rules for washing babies,
Abnormal development of the urinary system, which impede the normal passage of urine,
Congenital malformations of the kidneys,
Excess Vitamin D,
Transferred infectious diseases that contribute to the fall of the immune forces of the body.
Treatment of pyelonephritis in infants
Treatment of pyelonephritis in infants is based on the following principles:
Compliance with bed rest during the entire febrile period,
Refusal from the introduction of complementary foods, without limitation in the natural protein food,
Timely hygiene measures in compliance with the rules of washing babies,
Symptomatic therapy using antipyretic, decontamination and infusion drugs,
Perform antibiotic therapy.
The main condition for ridding the child of the disease is antibacterial therapy, which is carried out in three stages. At the first stage, which lasts from 10 days to 2 weeks of the child, the choice of the doctor is treated with the help of protected penicillins: Amoxiclav or Ampicillin in combination with Sulbactam. The third generation cephalosporins are also used: Cefotaxime, Ceftazidime, Cefixime, Ceftriaxone, Ceftibuten. When the disease is severe, aminoglycosides (Nethromycin, Gentamicin, Amikacin), 4th generation cephalosporins (Cefepime) or carbapenems (Imipenem, Meropenem) are administered.
The second stage of treatment is reduced to uroseptic therapy, which is performed for 2-3 weeks. It is performed using 5-nitrofuran derivatives (Furagin, Furamag), and non-fluorinated quinolones (Negram, Nevigremon, Palin after a year), combined sulfonamides (Co-trixomazole is allowed after 2 months).
The third stage of treatment is prophylactic anti-relapse therapy. To do this, for a long time (possibly up to a year), nitrofuran preparations - Furagin, Furamag - are given to the child and they carry out a course phytotherapy, preferably monophytotherapy taking into account individual intolerance.
As phytopreparations for the prevention of pyelonephritis in infants, you can use Canephron H, offering the child 15 drops up to 3 times a day.
Probiotics (Linex, Acipol) are used to treat dysbacteriosis. During the month, the child is given vitamin A, B6, E, which is a prerequisite for antioxidant therapy. Subsequently, it is conducted courses.
The child after an episode of acute pyelonephritis is subject to follow-up for five years, and during relapses - constantly.
Education: The diploma in the specialty “General Medicine” was obtained at the Volgograd State Medical University. Immediately received a specialist certificate in 2014