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Questions posted in the
The Urology Forum have been answered by urologists from Henry Ford Health System and by Dr. Kevin Pho.
Question Title: 11 mo. old with VUR. Can antibiotic cause lack of appetite w/ slow weight gain?Forum: The Urology Forum
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My daughter was diagnosed with VUR, rated at about 3-3 1/2 in severity, on the left side at the age of 7 mo. She had two kidney infections that allerted my doctor to obtain a VCUG and renal ultrasound. She has been on Septra since. She had quite a bit of vomiting and spitting up on the antibiotics given for the first two infections. I am now concerned that the Septra is affecting her as well. She is falling off the growth chart where her weight is concerned and is still spitting up a lot and not eating or taking in fluids well. Would it be wise to try a new antibiotic or to suggest that maybe the surgery be performed? I have agonized over this for months as is it emotionally difficult to watch your baby seemingly deteriorate from a healthy, hearty newborn to a small, cranky infant. I just want her to enjoy life and not be so miserable! Thanks,
________- Dear Cyndi, I sympathize with your situation and think that your child is being treated properly. The antibiotic septra is a good prophylactic antibiotic, in fact it would be my first choice as well. However, it is not the only choice and there are other antibiotics that can be used safely in children as prophylaxis (amoxicillin,Furidantin). Surgery is not performed unless there are indications. These would be, progressive VUR with renal insufficiency, break through infections on antibiotics, renal scarring or unresolved reflux over several years that is unlikely to change. Before you do anything, you should talk to a Urologist or even a pediatric Urologist if they are available. If you have already seen a Urologist, you could discuss changing the antibiotic. Another option to determine if the left kidney has been damaged, would be to do a DMSA renal scan, particularly if the urinary tract infections were associated with high fever. Overall, children do very well with prophylactic antibiotics and you can follow the kidney and bladder over time with repeat Ultrasounds, and VCUGs. Reflux can run in families and sibling screening is may be necessary. The same studies, would be utilized the ultrasound and VCUG. Typically, in sibling screening an ultrasound is done. If this is negative and the child has not had a UTI, then observation would be best. If the US is positive, then this would be followed by a VCUG to look for reflux. Good Luck! This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568). Sincerely,
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