Referrals from primary care of children with UTI should in most instances be dealt with by a general paediatrician following the NICE guidelines.
If a general paediatrician needs advice about the management of a child with UTI their first point of contact should be the local SPIN doctor. This will lead to one of four outcomes:
- The SPIN will be able to deal with the problem
- The SPIN will consult a paediatric nephrologist or urologist in Cardiff or Liverpool (for North Wales)
- The SPIN will arrange for the child to be seen in their joint clinic
- The SPIN will arrange urgent referral to Cardiff or Liverpool (for North Wales)
Indications for referral to / discussion with a paediatric nephrologist
- Bilateral renal scarring
- Renal impairment
- Recurrent pyelonephritis
- Persistent wetting in child over 2 years of age
Indications for referral to / discussion with a paediatric urologist
- Recurrent UTIs in the presence of vesicoureteric reflux
- Possible urinary tract obstruction