Please refer to the Bristol Children's Hospital guidelines for management of UTI's in children and local antibiotic guidelines.
- Urinary Tract Infection In Children Management And Referral
- 5. Infections Guidelines (Remedy BNSSG ICB)
Reflecting on the learning from a previous BrisDoc audit, please take particular note to:
- Ensure that UTI is considered, and a urine dip undertaken for all children presenting with fever without obvious focus. Clinical observations (HR, RR, Temp) should be clearly recorded in children presenting with fever. Use the NICE guidance for the management of feverish illness in children, to guide assessing severity of illness.
- In children aged < 3 months, dipstick analysis is not reliable (because normal frequent passage of urine does not allow time for nitrite formation). In this age group please use clinical criteria for decision making where urine stick testing does not support your clinical findings, and be sure to clearly document your rationale. If UTI is suspected in children aged under 3 months, refer/ discuss urgently with a paediatric specialist for probable treatment with parenteral antibiotics.
- If UTI is suspected in children aged 3 months or older, perform dipstick analysis. Pay particular attention to the presence or absence of nitrates.
- Common differentials for a diagnosis of UTI include vulvovaginitis in younger girls. Clinical examination, with appropriate consent of the parent, can often avoid the need to treat with antibiotics
Alternative keywords: Paediatric UTI, child fever, fever ?cause, paediatric assessment, child assessment