Thousands of children in the UK are missing out on vital treatment for common urinary tract infections (UTIs), risking long-term damage to the bladder and kidneys, experts have warned.
Official NHS guidance states that young people with hard-to-treat UTIs should be looked after by hospital specialists. However, insiders have told The Mail on Sunday that too few GPs are organising referrals, denying children effective medication.
Instead, young patients are ‘fobbed off’ with antibiotics that don’t work, leaving them in constant pain.
Urinary tract infections are the most frequent childhood bacterial infection, affecting around one in ten girls and one in 30 boys.
Urinary tract infections are the most frequent childhood bacterial infection, affecting around one in ten girls and one in 30 boys
In most cases it can be treated quickly with a short course of antibiotics, which destroys the bacteria that causes the problems. But for some, this is ineffective and the infection returns
In most cases it can be treated quickly with a short course of antibiotics, which destroys the bacteria that causes the problems. But for some, this is ineffective and the infection returns.
In these cases, experts say that specialist intervention is crucial, as patients need an extended course of antibiotics, which GPs are unlikely to prescribe due to concerns about antibiotic resistance – when the bacteria develops the ability to defeat the drugs designed to kill them. A specialist may also prescribe drugs which can sterilise the urine in the bladder.
According to patient group the Chronic Urinary Tract Infection Campaign, many GPs are unaware that children with UTIs require specialist treatment.
The group also says that GPs who are aware may struggle to find anyone to refer the patient to, due to a shortage of consultants specialising in child urine infections.
‘We regularly hear from worried parents who have a child with a drug-resistant UTI who can’t get a referral,’ says Alison Pearce, a director of the patient group. ‘Some GPs have outdated views about these infections and don’t believe they need the attention of a specialist.
‘We’re also worried about the number of parents who tell us they’ve got a referral from their GP only to find out there is no specialist who can see them.
‘We believe there aren’t enough NHS doctors who specialise in UTIs in children. Even big hospitals don’t have the resources to treat these cases.’
UTIs occur when bacteria gets into the urinary tract – a catch-all term for the bladder, kidneys and tubes connected to them. Sufferers typically experience a burning sensation when urinating, as well as difficulty passing water and a high temperature.
Left untreated, a UTI can lead to kidney damage and even sepsis – a potentially fatal immune system reaction to an infection.
Another danger of poor treatment is the risk that infections will become harder to treat and even resistant to normal antibiotics, meaning the problem keeps recurring. This happens because, over time, all bacteria develop a defence against drugs they frequently come into contact with.
According to the World Health Organisation, these so-called super bugs already kill 1.2 million people worldwide each year and will lead to the deaths of more than ten million a year by 2050.
Studies suggest that around a third of childhood patients will go on to experience chronic UTIs, classified as three or more infections a year.
‘Every year we hear from an increasing number of parents terrified as their children have chronic UTIs that are not responding to antibiotics,’ says Ms Pearce.
Yet experts say there are currently few options for worried parents. ‘Complex cases can be difficult for a GP to manage, as they may not have a good understanding of how to treat these infections,’ says Dr Cat Anderson, a Staffordshire-based GP who also runs a UTI clinic.
But specialists can offer effective treatment. Studies show that extended courses of antibiotics, as well as other drugs such as the antiseptic medicine Hiprex, can stop the infections returning for good.
One patient who’s struggled to get effective treatment is four-year-old Ellie Lury from Exeter.
Ellie has suffered six infections in less than three months, which her mother Sam describes as ‘traumatising’.
‘She has been in constant pain since they began and it’s got to the point where she’ll avoid using the toilet because it hurts so much,’ says Sam, 34. ‘Ellie was meant to start school last week but she’s had to stay at home because of the infection. She was so sad about it.’
Urine tests, requested by Ellie’s GP, show that she is suffering from a drug-resistant strain of E.coli.
Despite this, the GP refused to refer Ellie to a specialist.
‘The GP said that she hadn’t had the infection long enough for it to be considered chronic, so her case wasn’t serious enough,’ says Sam. ‘He said we had to try another short course of antibiotics instead.
‘Ellie is really struggling and so am I, as I’m up with her all night when she’s in pain. To not even consider referring her to a consultant seems awful.’
Sam has since decided to take Ellie to a private paediatric urologist. ‘Ellie needs to see someone who knows what they’re doing,’ she says. ‘My biggest fear is that this infection never goes away.’