NICE updates guidance for treating UTIs in children

NICE has advised healthcare professionals (CG54) to use urine dipstick tests for children before deciding whether to prescribe them antibiotics for urinary tract infections (UTIs).

The guidance applies to patients aged from birth to 16 years of age that present with symptoms of a UTI. In children aged less than three months a dipstick test should not be used, but they should be referred to a paediatric specialist while a urine sample is sent for laboratory tests. In children aged between three months and three years, if the dipstick test is negative the guidance says that they should not be prescribed antibiotics. In children over three years, however, antibiotics may be given if the dipstick urine test shows mixed results and the patient demonstrates symptoms of a UTI.

The guidance also gives clear information that if a child has a recurring UTI, and if their symptoms have not responded to treatment in 24-48 hours, then the urine samples should be sent for laboratory analysis.  

The new recommendations are an attempt to fight increasing antibacterial resistance. UTI infections are very common in children, with 2% of girls and 3.7% of boys estimated to experience a UTI by the time they reach the age of one year. A urine dipstick is an easy method to discern if a child’s body is already managing to fight an infection.

Professor Gillian Leng, Director of Health and Social Care at NICE, said: “These new recommendations will support GPs and healthcare professionals in deciding whether or not to prescribe an antibiotic. We need to ensure medicines are only used when needed, or risk a future where they will not work at all.”

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