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a urine analysis imageOctober 3 2017

Health professionals should use a dipstick urine test to decide whether antibiotics are needed for urinary tract infections in children, NICE has said.

 Updating its clinical guidelines CG 54, ‘Urinary tract infection in under 16s: diagnosis and management’, NICE has added information around testing, including to:

  • refer all infants under 3 months with a suspected UTI to paediatric specialist care, and send a urine sample for urgent microscopy and culture;
  • use dipstick testing for infants and children 3 months or older but younger than 3 years with suspected UTI.

It also wants urine samples to be sent for culture in:

  • infants and children who are suspected to have acute pyelonephritis/upper urinary tract infection;
  • infants and children with a high to intermediate risk of serious illness;
  • infants under 3 months;
  • infants and children with a positive result for leukocyte esterase or nitrite;
  • infants and children with recurrent UTI;
  • infants and children with an infection that does not respond to treatment within 24–48 hours, if no sample has already been sent;
  • cases where clinical symptoms and dipstick tests do not correlate.

“A dipstick test offers a quick and painless way to check a child’s urine for signs that their body is fighting an infection,” says NICE. “Children between the age of three months and three years should not be given antibiotics if their dipstick test is negative. Children over the age of three years may need to be given antibiotics if their urine dipstick analysis shows mixed results and they have other obvious symptoms of a UTI (for example painful urination).”

Links:
NICE announcement      
NICE Clinical guideline [CG54] ‘Urinary tract infection in under 16s: diagnosis and management’

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