Clinical Pathway for the Evaluation and Treatment
of Healthy Children with Possible UTI

Review Risk Factors/Symptoms and Determine Need for POC Urine Dipstick
Healthy Child > 56 Days to < 24 mos or Not Toilet-trained Toilet Trained Child/Adolescent
  • Use UTICalc   to estimate probability of UTI
  • Risk factors:
    • Female or uncircumcised male
    • Fever ≥ 48 hrs
    • Age < 12 mos
  • Children with prior UTI or multiple risk factors have higher risk for UTI
  • Consider a lower threshold for screening infants < 3 mos
Not Toilet Trained Toilet Trained
  • < 3 mos:
    • Catheterization for urine POC and culture
  • ≥ 3 mos:
    • Bag specimen for urine POC
    • Catheterization for urine culture if urine POC meets criteria for possible UTI (UTICalc  )
    • Consider catheterization for urine POC and culture if high probability of UTI or delay in obtaining bag specimen
    • Nursing Care
  • Clean-catch specimen for POC urine
  • Send clean-catch specimen for culture if meets POC urine criteria for possible UTI
  • Nursing Care

Empiric Treatment for Possible UTI Based on Urine POC Testing

Review Admission Considerations
  • Consider admission if:
    • Ill appearance/concern for urosepsis/concerning VS
    • Moderate/severe dehydration
    • Vomiting, inability to tolerate oral fluids or antibiotics
    • Concern for follow-up
    • Consider lower threshold for admitting infants < 3 mos