Urinary tract infection in under 16s: diagnosis and management

Context

In the past 30 to 50 years, the natural history of urinary tract infection (UTI) in children has changed as a result of the introduction of antibiotics and improvements in healthcare. This change has contributed to uncertainty about the most appropriate and effective way to manage UTI in children, and whether investigations and follow up are justified.

UTI is a common bacterial infection that causes illness in babies and children. It may be difficult to recognise UTI in children because the presenting symptoms and signs are non-specific, particularly in babies and children younger than 3 years. Collecting urine and interpreting results is not easy in this age group, so it may not always be possible to unequivocally confirm the diagnosis.

Current management, which includes imaging, prophylaxis and prolonged follow up, has placed a heavy burden on NHS resources. It is based on limited evidence, is costly and unpleasant for children and is distressing for their parents or carers. This guideline has been developed with the aim of providing guidance on several aspects of UTI in babies and children from birth up to the age of 16 years.