Recurring UTI in 6 yr old DD - desperate for some help

[igetmorelovefromthecat]

My 6 year old dd started having smelly wee back in March (a very strong smell of fish). I did some research on the net and realised it was probably a UTI, took her to docs and it was confirmed to be just that. Given antibiotics, i don't really like the things as I have had a terrible time in the past with doctors overprescribing them to me and making the infection resiliant, but I gave them to her, and they did work in that the symptoms disappeared for about a week then came back again.

More, stronger antibiotics prescribed and doc assured me these would do the trick. Exactly the same result as previous time, it came back after a week. She was sent for a scan at the hospital and it was found that her bladder and kidneys were fine, everything as it should be.

I took her to the homeopath and she was given a remedy which made the smell go away for about 2 months. The infection also made her lose all ability to know when to go for a wee and she would have accidents pretty much every day at school and would need changing. Not full on weeing herself but just enough to make her pants a bit damp and therefore smelly as her wee smells so bad. But after the homoepath she literally overnight stopped wetting herself.

Unfortunately the remedy stopped working and since then she has tried other homoepathic remedies but they have done nothing at all. The symptoms all returned, worse than ever, and she also started wetting the bed which is something she had never done before. The other kids at school started noticing and she has been really embarrassed about it, I feel so sorry for her. So went back to docs and was prescribed more antibiotics. They didn't work at all, and a urine sample showed that the infection had now become resistant to that type, she was presribed a different sort which she finished a week ago and they did seem to work, but I noticed tonight that the smell had returned.

I am desperate here as the docs don't seem to have any answers and all they can/will do is prescribe yet more antibiotics that don't bloody work and are making the bugs stronger with every course that she takes.

Does anyone have any ideas of where I can go next with this? I would be hugely grateful to anyone who can help.

re lactulose - try upping dose, it is just very concentrated sugar soln. so can't do any harm. My dd was on 3 tsp twice a day to manage a poo issue. It works by attracting water to make poo softer so need to drink loads to make it work properly.

www.bbc.co.uk/news/health-11539933

Right - been to the docs today so have an update!

The sample taken on Tuesday is testing positive for coliform so that means the last lot of ABs did nothing at all. I got a bit forceful with the doc and said I wanted her to see a urologist, he is going to do an urgent referral and said he hopes she will be seen in 2-3 weeks.

He has prescribed her something called Senna for her constipation, I asked about Movicol but apparently that is only licensed for over 12s.

He also prescribed an AB called Nitrofurantoin. I am very reluctant to give her this as none of the other ABs have worked and it is just getting more and more resistant. I asked why he thinks none of the ABs are working and he said he didn't know why but there must be a pocket somewhere that the ABs cannot get to. Which makes me wonder why these ones given today will work.

What do you think I should do? Start this course or wait until she has been to the urologist before I give her any more? It will be her third course in a month.

P.S. Yes she does go to the toilet regularly at school, they are really good about getting her to go as they are aware of her UTIs.

Give her the AB's, they can't hurt and will hopefully make her feel more comfortable.

Senna is a laxative, DD is on it alongside Lactulose. It is absolute bollocks about Movicol, they have an adult version and a child's version.

One of the reasons that our GP always sends urine samples to be lab tested is so that they can find which antibiotic the bacteria in the urine is sensitive to. So it could simply be that the previous antibiotics weren't the right ones for that particular bacterium.

Please give your DD this medecine because this UTI mustn't continue. Given what you have already said about your doctor I would also be inclined to switch to another practice.

Her samples are always sent away to the lab and I have always waited to find out which ABs the bugs are responding to before I get her prescription, so that is why I am confused about what is happening as in the lab it responds but when she takes that AB it never works. Now there are only 2 different types that it is responding to in the lab - the sort she just took (which didn't work) and the ones she got today.

Oh, sorry, I didn't realise. But it definitely sounds like it is time your daughter is referred. This can't continue.

Has she never had a bladder reflux test or a DMSA scan?

No she hasn't but I think that will be what happens when she sees the urologist.

Didn't start the ABs tonight - so unsure about what to do.

DDs BF had reflux. It was not diagnosed until she was 4 and by then one of her kidneys was damaged beyond repair and the other one only functions at 70%. Her mother was told that it should have been diagnosed from prenatal scans.
Interestingly she had a lot of constipation problems when she was younger and this probably disguised the UTIs.

She was finally diagnosed when she had a specific uti (don't know which one) which the gp said should always be referred.
She has had several operations which now finally seem to solved the reflux. She was also on long term antibiotics for quite a few years.

Bruffin - if it helps your DD's bf's mum I haven't had any serious side effects form having mangey kidneys

OP, I'm a doctor, it is vital that you give your daughter the antibiotics prescribed. They will not harm her in any way, unless she was unfortunate enough to be allergic to them. They do not make the bacteria more resistant in her, only on a poulation level if inappropriately used. The dipstick test your Gp does can indicate the possibility of a UTI, but cannot confirm it. Because it takes 48h to culture the urine specimen in the lab, and maybe longer for result to get to you, it is perfectly routine that you are prescribed a broad-spectrum antibiotic when first seen, which you should start then. When the culture comes back, it may show that there is no UTI, in which case you have just had a couple of days of antibiotic not needed. The bacteria (if confirmed)may be sensiive to a different antibiotic, in which case you would have a new prescription when the culture comes back. This is not particularly common, which is why it's important to start treatment straight away. If you leave your dd with no treatment of a severe UTI for 2-3 days, this could progress to kidney infection (pyelonephritis) which can mean hospitalisation and the risk of kidney damage.

I second all the advice given above regarding her needing referral to a urologist. In the meantime I would advise you to try very hard to improve her constipation, and trust that antibiotics are the ONLY thing that will treat infection and are vital in her case. Long-term low dose antibiotics are pretty common in childhood, and in pregnancy (I work in obstetrics).

Best wishes, you must be awfully worried, but I'm sure she will improve with the appropriate investigations.

I was wondering whether she drinks enough - not drinking enough can increase risk of UTI and can cause constipation as well? Hope you can sort it out. Would take the AB though just because risk of kidney damage.

eeky - if you are reading this many thanks for your post, I have only just seen it as I did not check the thread again after the initial flurry.

Well an update - the UTI is still there and worse than ever, judging by the smell. DD has now had I think 11 courses of ABs and none have cleared the infection, she has not had a single test come back clear from the lab (I always take a sample to the docs after a course to see if it has gone). Within 3 days of ABs finishing the smell is back and it seems to be getting worse every time.

She went to see the paediatrician again at the end of Oct, and she has referred her tests to check for kidney damage and kidney reflux, a renogram MAG3 with diuretic and a Mict Cystourethrogram. She also prescribed her a low dose AB to take long term, at the time of the appt she had just finished a course of high dose ABs, but within a week of seeing her the infection was back, even on the low dose. So I stopped giving her the low dose one and since then she has had 3 more courses of high dose ABs, but same result as usual - it just comes straight back again.

So I have finally got a date for these tests in hospital, on Thursday next week. I am really concerned about whether it is the right thing to do as according to the paediatrician, even if the tests do show reflux or kidney damage, the treatment will be the same as what is happening now, i.e. yet more ABs that DON'T BLOODY WORK! None of them have worked. Isn't the definition of madness doing the same thing over and over again and expecting a different result?!

And I am also just scared about the safety of these tests, she will be injected with a radioactive material and in the leaflet that I was sent by the hospital it warns against prolonged cuddling after the tests and coming into contact with her urine...surely this is not good? And pointless as far as I can see if they are just going to give her more AB's? I know kids have been through far worse than this but she has never even had an injection, I am a bit of a hippy I suppose and getting her injected with radioactive stuff really goes against my parenting instincts. I told her yesterday that she is going for these tests and she was really upset, I am worried about us both going to pieces on the day. Of course I want her to get better but I am losing faith pretty quickly in the doctors.

Hi I was scanning through internet for myself and came across this discussion. You might have had the tests now but I just thought I'd add a note. My daughter was routinely sent for an ultrasound scan following a uti (which did clear up with AB trimethoprim) and during this we found she had a horseshoe kidney, ie they didn't separate when she was forming so she has one joined kidney. This will not be your experience but I wanted to tell you that she had the test and I was also worried, but it meant that the consultant could follow what was going on when she drank and then passed urine and she was fine afterwards, but I agree its scary. She later had to have an mri scan to check things were ok and tho it wasn't nice she came through it fine and now says do you remember the time.... we are lucky to live near oxford and the childrens hospital is fab with childrens videos on the ceiling etc. The other thing I wanted to say was she was on low dose trimethoprim daily for about three years with no ill effect and has now been given the all clear. There is a brand of trimethoprim called Pinewood, it was in a red box, this doesn't taste quite as foul as the others acording to my daughter and she would take this happily whereas when I went to another chemist and had another brand she created a real fuss about taking it. Hope things go well for you.