Approach to managing UTI in children

While awaiting the results of culture and susceptibility testing, start empirical therapy for children with symptoms of urinary tract infection (UTI).

Note: UTI in children is commonly acute pyelonephritis; it is difficult to distinguish pyelonephritis from cystitis, particularly in infants.

UTI in children is commonly acute pyelonephritis; it is difficult to distinguish pyelonephritis from cystitis, particularly in infants. The approach to management of UTI in children depends on the child’s age and clinical presentation:

for neonates and children younger than 3 months, see Urinary tract infection in neonates and children younger than 3 months
for children 3 months or older with bacteriuria and localising symptoms (such as dysuria, frequency, urgency or lower abdominal discomfort) who do not have fever (38°C or higher) or loin pain or tenderness, treat as acute cystitis
for children 3 months or older with bacteriuria and either fever (38°C or higher) or loin pain or tenderness, treat as acute pyelonephritis.