By Halima Janjua, MD
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Diagnostic and treatment guidelines for urinary tract infection (UTI) issued by the American Academy of Pediatrics fall short of providing all the answers a pediatrician may need. The same goes for guidelines on primary vesicoureteral reflux (VUR) issued by the American Urological Association.
Both sets of guidelines fail to address frequent clinical challenges — or at least fail to do so with the specificity that real-world practice can demand. To fill this void, I and my colleagues in Cleveland Clinic Children’s Centers for Pediatric Nephrology and Urology generally rely on the principles outlined below to handle UTI and VUR challenges for which guideline recommendations are lacking .
I invite perspectives on these principles — and additional recommendations for addressing neglected challenges in UTI/VUR management — from colleagues across the nation.
Dr. Janjua is a pediatric nephrologist in Cleveland Clinic Children’s Center for Pediatric Nephrology.