[Urinary tract infections in pediatric practice--which new aspects must be considered?].

The prevalence of urinary tract infections varies markedly with sex and age. They are caused mainly by colonic bacteria. Acute cystitis should be promptly treated either with cotrimoxazol or coamoxyclav to prevent its possible progression to pyelonephritis. In acute febrile infections suggestive of pyelonephritis, the initial use of broad-spectrum antibiotics capable to reaching significant tissue levels is advised, mostly amoxycillin with an aminoglycoside. A variety of functional voiding disorders including bladder instability, detrusor-sphincter dyscoordination, postponing syndrome or lazy bladder syndrome have been identified since the early 1970s, each with its own characteristics and clinical importance. Functional voiding disorders are nowadays a major cause of recurrent urinary tract infections in children. A careful investigation to confirm or exclude functional voiding disorders is warranted in children with recurrent urinary tract infections. Management will vary according to the type and severity of the dysfunction present.