Urinary tract infections (UTIs) affect up to 5% of children and adolescents in modern Western society. They occur because of either a deficiency in host defense mechanisms or because of bacterial virulence and adherence factors. Vesicoureteral reflux (VUR) is the single greatest risk factor to the kidneys in the development of recurrent UTIs. The general consensus is that evaluation should include voiding cystourethrography and renal and bladder ultrasound with perhaps the concomitant use of urodynamic characterization of the bladder if clinically warranted. Diagnosis should be made from clinical impression and urinalysis and therapy begun at once. UTIs should be treated with at least 3 days of an effective antibacterial agent but long-term antibacterial suppression is required in those patients who have anatomic or functional abnormalities.
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