• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of archdischArchives of Disease in ChildhoodVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Arch Dis Child. Dec 2002; 87(6): 530–532.
PMCID: PMC1755815

Unexplained extra visits to general practitioners before the diagnosis of first urinary tract infection: a case-control study


Aims: To determine: (1) whether children diagnosed with a urinary tract infection (UTI) visited their general practitioner (GP) more frequently before the diagnosis of UTI was established compared to children never diagnosed with a UTI; and (2) whether those children with evidence of renal scarring at their first diagnosed UTI visited their GPs more frequently before diagnosis compared to children who did not have evidence of renal scarring when their first UTI was investigated.

Methods: Case-control study of 77 children with a UTI identified from a hospital radiology database (37 with and 40 without renal scarring), and 77 age, sex, and general practice matched controls. Main outcome measures were entries in general practice clinical records for types of illness, antibiotic prescriptions, and urine samples requested prior to the diagnosis of first UTI (cases) or equivalent time periods for controls.

Results: Cases had a mean 2.94 additional visits or 21% more visits (95% CI 1% to 41%) in the period (mean 2.4 years) prior to the visit at which their first UTI was diagnosed, including a mean 2.5 additional visits or 23% more visits for infectious illness (95% CI 1% to 45%). The cases had 114% (95% CI 41% to 184%) more visits for symptoms relating to the genitourinary tract, though the actual number of these visits was small. They were febrile at 49% more visits (95% CI 1% to 99%) and received significantly more courses of antibiotics than controls (5.2 v 4.1). They had more urine samples requested (37 v 3). Both the cases with and without renal scarring had similar excess GP visits.

Conclusion: Compared to controls, children diagnosed with a first UTI had more visits at which symptoms of infection were recorded and more antibiotics prescribed prior to the visit at which the first UTI was diagnosed. These excess visits may have included undiagnosed UTIs. Both those with and without renal scarring had a similar degree of excess visits; additional aetiological factors must have played a role in scar formation.

Full Text

The Full Text of this article is available as a PDF (83K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Dickinson JA. Incidence and outcome of symptomatic urinary tract infection in children. Br Med J. 1979 May 19;1(6174):1330–1332. [PMC free article] [PubMed]
  • Brooks D, Houston IB. Symptomatic urinary infection in childhood: presentation during a four-year study in general practice and significance and outcome at seven years. J R Coll Gen Pract. 1977 Nov;27(184):678–683. [PMC free article] [PubMed]
  • Jakobsson B, Esbjörner E, Hansson S. Minimum incidence and diagnostic rate of first urinary tract infection. Pediatrics. 1999 Aug;104(2 Pt 1):222–226. [PubMed]
  • van der Voort J, Edwards A, Roberts R, Verrier Jones K. The struggle to diagnose UTI in children under two in primary care. Fam Pract. 1997 Feb;14(1):44–48. [PubMed]
  • Jacobson SH, Eklöf O, Eriksson CG, Lins LE, Tidgren B, Winberg J. Development of hypertension and uraemia after pyelonephritis in childhood: 27 year follow up. BMJ. 1989 Sep 16;299(6701):703–706. [PMC free article] [PubMed]
  • Berg UB, Johansson SB. Age as a main determinant of renal functional damage in urinary tract infection. Arch Dis Child. 1983 Dec;58(12):963–969. [PMC free article] [PubMed]
  • Smellie JM, Poulton A, Prescod NP. Retrospective study of children with renal scarring associated with reflux and urinary infection. BMJ. 1994 May 7;308(6938):1193–1196. [PMC free article] [PubMed]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Group


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...