الفهرس 
The role of nephrons in kidney functionOnly 14 pages are availabe for public view
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Abstract
Urinary tract infection (UTI) is one of the most common bacterial infections in infants and children and the most common bacterial infection in infants under three months.
Although the diagnosis and treatment of urinary tract infections (UTI) are relatively straightforward, a large proportion of the population may be unnecessarily exposed to antibiotics while waiting for the results of urine culture, with implications for costs and antibiotic resistance.
The need for reducing unnecessary antibiotic treatment is being emphasized in the management of urinary tract infections (UTI), a disease frequent in childhood. An ideal test should provide early diagnosis without the waiting times of urine culture, but even a simple test of exclusion could significantly improve patient management.
Urine culture is the gold standard in UTI diagnosis, but at least 24–48 h is required before results become available. Thus, antibiotics may be started in a symptomatic patient on the basis of clinical suspicion and chemical and urinary microscopic analysis, to be later withdrawn if the results of culture do not confirm the presence of UTI.
Our study include two hundreds child (1-15ys) attended to Berket Alsabaa Hospital (admitted or visited the outpatient clinic), from rural and urban areas of Menofiya governorate, suffering from urinary tract
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symptoms (frequency, dysuria, fever, and suprapubic pain) and had no antibiotics for 3 days before collection of samples.
The children included in the study had:
1- Complete history tacking.
2- Complete physical examination.
3- We done the following investigations:
- Routine urine analysis.
- Dipstick analysis for leucocyte esterase and nitrites.
- Bacterial colony count.
- Urine culture.
The number of our patients was 200 child, (91) male and (109) female. We classify them according to age into three groups. 1-4 years: 81 cases (40.5%), 4-9 years: 87 cases (43.5%) and 9-14 years: 32 cases (16%). We reported that 107 cases had negative urine culture (53.5%), while 93 cases had positive urine culture (46.5%).
We developed a score based on our results according to age, urine analysis (pus cell and RBCs), dipstick (LE and nitrites) and BCC. Patients who take score 3 or more should receive antibiotics immediately before appearance of result of urine culture, while patients who take score below 3 should not receive antibiotics until the appearance of result of urine culture. The sensitivity and specificity of score 3 was 88% and 90%.
So, by using our score system, we can decrease the misuse of antibiotics in children having symptoms of UTI.