ICU and Inpatient Clinical Pathway for Inpatient Management of Infants ≤ 56 days or Preterm Infants with Corrected Gestational Age (CGA) of ≤ 48 weeks with Suspected or Confirmed UTI Diagnosis

UTI Confirmed
Antibiotic Strategy
  • Broad-spectrum antibiotics until culture sensitivities available
    • Treat for 7 days
    • Longer duration may be appropriate for infants who are slower to respond to therapy or with complicated infections
    • Consider ID Consult
Diagnostic Imaging and Prophylactic Antibiotics
  • Renal Bladder Ultrasound (RBUS)
First UTI with NORMAL RBUS in preterm infants or NICU patients
First UTI with NORMAL RBUS in healthy, full term infants on IP units
or ≥ 2nd UTI
  • Urology consult
  • Obtain Voiding Cysto-Urethrogram (VCUG)
  • Consider Prophylaxis
Discharge Plan
  • Urology follow up based on consult recommendations
  • Discuss potential benefit of circumcision, prior to discharge
  • Parent Education
  • Home Instructions
Posted: March 2020
Revised: August 2022
Authors: E. Brandsma, MD; T. Kolon, MD; S. Coffin, MD; L. Goldsmith, MD; D. Flannery, MD; J. Hart, MD