Clinical Practice Guideline for the Diagnosis and Treatment of Urinary Tract Infection in Children From 8 Days to 5 Years of Age

Urinary tract infection (UTI) is one of the most common bacterial infections in infants and young children, with a prevalence of 7% in infants with fever. This clinical practice guideline (CPG) provides an update of the literature and clinical recommendations of the 2011 American Academy of Pediatrics (AAP) CPG on diagnosing and managing UTI in infants and children. It is designed to provide guidance for pediatricians and other pediatric clinicians on the diagnosis and management of UTIs in infants and children 8 days to 5 years of age and is intended for use in children with low medical complexity across a variety of settings. The CPG is accompanied by 3 technical reports to further elucidate the data that guided the development of recommendations and to establish criteria for the diagnosis of UTI. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the certainty of the evidence and formulate recommendations and good practice statements, including GRADE evidence-to-decision frameworks, which were reviewed by internal and external contributors. The CPG provides 8 Key Action Statements (2 strong and 6 conditional clinical recommendations, ranging from low to very low certainty of evidence) and 4 Good Practice Statements regarding medical evaluation of suspected UTI, management of UTI specific to antibiotic treatment, and imaging modalities and prevention strategies for structural abnormalities, including vesicoureteral reflux, and bowel and bladder dysfunction evaluation and treatment.