Guidelines
Urinary Tract Infections

Urinary Tract Infections

Guideline Use

  • Age < 60 days
  • Abnormal genitourinary tract
  • Prosthetic material in urinary tract, including intermittent catheterization
  • Patient with sepsis
  • Immunocompromised patients

Diagnostics

Consider utilizing https://uticalc.pitt.edu

Non-Toilet Trained Children:

  • Risk factors include:
    • Fever ≥ 39.0ºC
    • Age < 12 months (age <6 months if male)
    • Fever ≥ 2 days
    • No other source of infection
  • For female and circumcised male: consider screening if 2 risk factors present and recommend screening if 3 risk factors present
  • For UN-circumcised male: consider screening if 1 risk factor present and recommend screening if 2 risk factors present

Toilet Trained Children:

  • Screening recommended if:
    • Symptoms are referable to urinary tract,
    • Prior history of UTI and fever ≥2 days, OR
    • Fever ≥ 5 days

Always obtain urine for BOTH microanalysis and culture

Infants and Non-Toilet Trained Children:

  • Urinary catheterization
  • If difficulty in obtaining and parental refusal, consider bag specimen but discuss with parents that if abnormal, will need to confirm with catheter sample

Toilet-Trained Children:

  • Midstream clean catch
  • UA suggestive of UTI if ≥ trace LE or ≥ 5 wbc/hpf
  • Catheterization specimen: ≥ 50,000 CFU
  • Clean-catch specimen: ≥ 100,000 CFU

Treatment

Additional Information

Last Updated: February 4th, 2022

  • Daria Thompson, MD, MPH
  • Yorgo Zahlanie, MD
  • Brandon Libby, MD
  • Emily Tilton, PharmD