Early and adequate treatment is essential. Investigations and treatment of UTI go side by side.

• Restoring and maintaining hydration, including correction of electrolyte abnormalities that are often associated with vomiting or poor oral intake, is important.
• Paracetamol for fever may be required.

Antibiotic:

• Until the result of culture and antimicrobial sensitivity tests are obtained, in acutely ill febrile child suggestive of pyelonephritis, should be treated with a 14-day course of a broad-spectrum antibiotic. Parenteral therapy with ceftriaxone (50-75mg/kg/day, maximum 2.0g) or ampicillin with an aminoglycoside such as gentamycin should be given.
• Oral third-generation cephalosporins such as cefixime alone are equally as sensitive as parenteral ceftriaxone.
• The oral fluoroquinolone ciprofloxacin is sensitive against resistant microorganisms, particularly Pseudomonas.
• In otherwise not so acutely ill child with UTI, co-trimoxazole or nitrofurantoin may be started orally.
• Therapy must be continued for 7-10 days.
• Treatment should be modified when the result of sensitivity is received.