Urinary tract infections in infants and children: Diagnosis and management

• Published in: Paediatrics & child health 2014-06, Vol.19 (6), p.315-319
• Main Authors: Robinson, Joan L, Finlay, Jane C, Lang, Mia Eileen, Bortolussi, Robert
• Format: Article
• Language: English
• Subjects: CPS Position Statement
• ISSN: 1205-7088; 1918-1485
• DOI: 10.1093/pch/19.6.315

Recent studies have resulted in major changes in the management of urinary tract infections (UTIs) in children. The present statement focuses on the diagnosis and management of infants and children >2 months of age with an acute UTI and no known underlying urinary tract pathology or risk factors for a neurogenic bladder. UTI should be ruled out in preverbal children with unexplained fever and in older children with symptoms suggestive of UTI (dysuria, urinary frequency, hematuria, abdominal pain, back pain or new daytime incontinence). A midstream urine sample should be collected for urinalysis and culture in toilet-trained children; others should have urine collected by catheter or by suprapubic aspirate. UTI is unlikely if the urinalysis is completely normal. A bagged urine sample may be used for urinalysis but should not be used for urine culture. Antibiotic treatment for seven to 10 days is recommended for febrile UTI. Oral antibiotics may be offered as initial treatment when the child is not seriously ill and is likely to receive and tolerate every dose. Children