Urinary Tract Infection (UTI) Management in Neonates Clinical Pathway — ICU and Inpatient
Urinary Tract Infection (UTI) Management in Neonates Clinical Pathway — ICU and Inpatient
Antibiotic Recommendations
- Continue broad-spectrum IV antibiotics pending organism ID and susceptibility.
- Consider narrowing antibiotics based on organism identification and susceptibility, and as clinically indicated.
- ID consult recommended for patients with a multidrug-resistant organism, fungal infection, uncommon urinary tract pathogen, or other questions regarding antibiotic selection or further workup.
- CHOP recommendation is 7-day course of antibiotics (longer durations may be appropriate for infants who are slower to respond to therapy or with complicated infections – consider ID Consult)
- Data are limited at this time regarding duration of antibiotics.
- CHOP recommendations for oral conversion
- Data are limited regarding optimal timing of oral conversion.
- Literature supports the safety of short-course intravenous antibiotic therapy and CHOP recommendations are as follows:
- Previously healthy infants with community-acquired febrile UTI, without underlying risk factors can be converted to oral antibiotics after demonstrating:
- Clinical improvement with resolution of fever and other presenting symptoms
- Negative blood culture
- Negative LP, if LP indicated by the Febrile Infant Clinical Pathway
- No other indications for further workup
- Tolerating oral intake
- Consider ID consult regarding oral conversion for infants with bacteremia, culture pretreated with antibiotics, or uninterpretable LP if obtained.
- Previously healthy infants with community-acquired febrile UTI, without underlying risk factors can be converted to oral antibiotics after demonstrating:
- Literature supports the safety of short-course intravenous antibiotic therapy and CHOP recommendations are as follows:
- Data are limited regarding optimal timing of oral conversion.
- Test of cure not routinely recommended, unless discussed with ID.