A single dose of antibiotic can sterilise the urine within hours, leaving a child treated for a UTI that can never be confirmed or a resistant organism that is never identified.
In a febrile infant or young child where UTI is possible, obtain a urine sample suitable for culture before the first dose unless the child is too unwell to wait. Bag specimens have high contamination rates: a negative bag urine is useful, but a positive one should be confirmed with a clean-catch, catheter or suprapubic sample before a diagnosis is recorded.
- Collect urine for culture before the first antibiotic dose wherever the child's condition allows.
- Use clean-catch, catheter or suprapubic samples for culture.
- Treat a positive bag specimen as unconfirmed.
- Send the sample promptly or refrigerate it to avoid overgrowth.
- Do not delay antibiotics in a child who is seriously unwell.
Why it matters
An unconfirmed UTI diagnosis can trigger unnecessary imaging and prophylaxis for years.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for paediatrics, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free