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
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