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Urolithiasis in children, especially in adolescents, is increasingly being diagnosed. Calcium-oxalate urolithiasis is the most common cause of urolithiasis with the predominance of metabolic causes in early childhood, especially hypercalciuria and hyperoxaluria. In adolescence, the causes of stone formation are increasingly similar to those in adults with an increasing role of hypocitraturia and decreased urinary excretion of glycosaminoglycans. Cystinuria and urinary stones are less common causes of urinary tract stones in childhood. Particular attention is given to the role of urine pH and increased urine saturation. Proper diet and fluid intake can prevent the return of most urolithiasis in children. Citrate therapy should be limited to those children in whom control of urine saturation by diet cannot be achieved. Specific therapy is used in children with metabolic/genetic diseases and for some of whom gene therapy may soon be possible. [ABSTRACT FROM AUTHOR]

Bacterial resistance to common chemotherapeutics and its implications for optimal antibiotic treatment choice was analyzed. The analysis included annual antibiotic resistance of Escherichia coli (E. coli), noninvasive (ninv) and invasive (inv) strains; Proteus mirabilis (P. mirabilis); Klebsiella pneumoniae (K. pneumoniae), ninv and inv strains; and Pseudomonas.aeruginosa (P. aeruginosa), ninv and inv strains. Based on the analysis, some conclusions can be proposed on the use of antibiotics in the treatment of urinary tract infections (UTI) in children, following the basic cost-benefit postulates. Bacterial resistance to ampicillin and sulfamethoxazole + trimethoprim compromises their use as first-line UTI treatment. If oral therapy is sufficient for treatment, the cost-benefit ratio for uroantiseptics (nitrofurantoin) is favorable; alternatively, first- or second-generation cephalosporin or amoxicillin + clavulanic acid antimicrobials can be used, favoring at the same time a wide range of cephalosporin/aminoglycoside antibiotics for parenteral treatment. Third-generation cephalosporin antibacterial line antibiotics should be applied in case of presumed bacterial resistance. Other antibiotics should only be used if antibacterial resistance has been proven or expected. [ABSTRACT FROM AUTHOR]

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