Pediatricians' group updates guidelines on UTIs in babies, kids
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As many parents know, urinary tract infections (UTIs) can strike babies and young children, too. Recently, the nation's leading pediatricians' group issued its first update since 2011 on diagnosing and treating these infections.
The new American Academy of Pediatrics (AAP) guidelines urge that any child between 2 months and 5 years of age be tested for a UTI within 72 hours of developing a fever with no apparent cause. The guidelines are published in the journal Pediatrics.
"UTIs are one of the most common bacterial infections in infants and young children, but reaching a diagnosis can be challenging," Dr. Brian Alverson, chairperson of the guideline panel, said in an AAP news release.
"The updated guideline aims to give clinicians clearer, more up-to-date direction for care based on evidence," he said.
By age 6, up to 7% of girls and 2% of boys will experience a UTI, and in 30% of cases, the infection will recur, according to the AAP. The infections are typically detected via urine tests, and antibiotics can usually clear up a pediatric UTI.
However, UTIs in infancy and childhood can have serious consequences, including damage to the kidneys, the AAP noted.
The new guideline expands its clinical focus to cover UTIs in children from 8 days to 5 years of age. The prior guideline covered children from 2 months to 2 years of age.
Regarding diagnosis, the guidelines recommend that doctors use a combination of tools, such as assessing symptoms and conducting urinalysis. If UTIs recur, doctors should consider constipation and bladder-bowel dysfunction as possible contributing factors.
For treatment, a shorter course of antibiotics (seven days or fewer) is recommended. Longer courses of the drugs are recommended only for infants, difficult-to-treat cases or children deemed to be at high risk.
The new guidelines stressed there's no "one-size-fits-all" approach to caring for pediatric UTIs.
"We recognize that physicians must make decisions based on the unique needs and symptoms of each individual patient," Dr. David Hains, vice chairperson of the guideline panel, said in the news release. "This decision-making ideally occurs through a shared process that considers the patient's and caregiver's values and preferences."
Publication details
Brian K. Alverson et al, Clinical Practice Guideline for the Diagnosis and Treatment of Urinary Tract Infection in Children From 8 Days to 5 Years of Age, Pediatrics (2026). DOI: 10.1542/peds.2026-078565
Journal information: Pediatrics
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