Clinical Pathway for the Evaluation and Treatment
of Healthy Children with Possible UTI
- Special Populations
- Urinary tract abnormality
- Neurogenic bladder
- Recent GU surgery
- Antibiotic Recommendations
- CHOP Antibiogram
Healthy Child > 56 Days to < 24 mos or Not Toilet-trained | Toilet Trained Child/Adolescent |
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Not Toilet Trained | Toilet Trained |
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Empiric Treatment for Possible UTI Based on Urine POC Testing
- Age < 24 mos:
- Use UTICalc with risk factors + POC urine dipstick results
- Age ≥ 24 mos:
- Symptoms + POC Urine Dipstick Results
Review Admission Considerations
- Consider admission if:
- Ill appearance/concern for urosepsis/concerning VS
- Moderate/severe dehydration
- Vomiting, inability to tolerate oral fluids or antibiotics
- Concern for follow-up
- Consider lower threshold for admitting infants < 3 mos
Discharge
- Outpatient Follow-up Actions When Culture Results Available:
- Definition of UTI
- Urine pathogens, common contaminants
- Review culture, susceptibilities
- Target or discontinue antibiotics
- Follow-up After Confirmed UTI:
Admit
- RBUS
- Target antibiotics to susceptibilities
- Transition to PO:
- Improving clinical symptoms
- Improving fever curve
- Follow-up After Confirmed UTI:
Posted: June 2011
Revised: August 2024
Revised: August 2024
Evidence
- Reassessment of the Role of Race in Calculating the Risk for Urinary Tract Infection
- UTI Sample Collection
- Contemporary Management of Urinary Tract Infection in Children
- Early Antibiotic Treatment for Pediatric Febrile Urinary Tract Infection and Renal Scarring
- Association of Renal Scarring With Number of Febrile Urinary Tract Infections in Children
- Does This Child Have a Urinary Tract Infection?
- Comparative Effectiveness of Antibiotic Treatment Duration in Children With Pyelonephritis
- Antibiotic Prophylaxis and Pediatric Urinary Tract Infection
- Antimicrobial Prophylaxis for Urinary Tract Infection in Children
- Impact of a More Restrictive Approach to Urinary Tract Imaging After Febrile Urinary Tract Infection
Educational Media
Related Links
CHOP Programs