Clinical Features
Infants and children presenting with an unexplained fever of 38°C or higher, for over 24 hours, should have a urine sample tested. Infants and children with an alternative site of infection should not have a urine sample tested. When infants and children with an alternative site of infection remain unwell, urine testing should be considered after 24 hours at the latest.
How to test
Urgent microscopy and culture <3years old
>3 or no microscopy, dipstick testing may act as a substituteUrgent microscopy and culture <3years old
Clean catch - less likely to be contaminated
Urine bags - useful to rule out, but not to rule in
Urine collection pads
Cotton wool balls, gauze and sanitary towels should not be used to collect urine in infants and children.
Treatments
Upper urinary tract infection - oral antibiotics (cephalosporin or co-amoxiclav) for 7 - 10 days
Lower urinary tract infections - oral antibiotics for 3 days.
Follow Up
< 3month old with UTI: 10% have bacteraemia, 13% have CSF pleocytosis however < 1% have meningitis !! #FOAMped
— Chris Partyka (@chrispartyka) April 19, 2014
References
http://learning.bmj.com/learning/module-intro/urinary-tract-infection-children-diagnosis-treatment-long-term-management-.html?moduleId=10011035&searchTerm=%E2%80%9CUTI%20children%E2%80%9D&page=1&locale=en_GB
http://www.enlightenme.org/the-learning-zone/node/4310
http://guidance.nice.org.uk/CG54/QuickRefGuide/pdf/English
http://dontforgetthebubbles.com/6-pem-papers-change-practice-6-getting-urine-neonates/
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