Reply to De Palma D.

The letter responds to a suggestion for a "top-down" approach to investigating and treating children with urinary tract infections (UTIs). The authors argue that this approach, which involves early 99mtechnitium-dimercaptosuccinic acid (DMSA) scans, is no longer promoted in medical guidelines and has higher costs and radiation exposure compared to other guidelines. They also highlight that recent research does not support the use of DMSA scans to guide antibiotic prophylaxis and voiding cystourethrography. The authors conclude that there is no strong evidence that recurrent UTIs in childhood lead to significant long-term health issues, making it unnecessary to subject all children with UTIs to radiation-based tests. [Extracted from the article]