Pediatric Urinary Tract Infection Treatment & Management:

Pediatric urinary tract infections are relatively common in children, with 8 percent of girls and 2 percent of boys having at least one episode by seven years of age.

Child urinary tract infection

For Diagnosis of UTI Symptomatic child with

Urine Routine

  • 10 WBCS / mm3 in un centrifuged urine sample

Urine C/S

  • Single pathogen
  • Colony count > one lac in mid stream sample
  • Any growth in supra pubic aspirate

Avoid bag specimen for C/S

How to collect Urine For Culture

  • Control temperature first with paracetamol
  • Hydrate the child well with any drink which child prefers
  • Clean genital area with mild soap and water
  • Keep the urine container handy but don’t open it
  • After half an hour of good hydration keep the genital area open
  • Once you see the child passing urine, open the container, collect urine, seal it immediately, surround it with ice and send it to lab immediately
  • Store the container in fridge at 4 C if delay expected

Before Starting antibiotics in a febrile child Please collect urine first

Urine Routine

  • Pyuria, Bacteriuria, Hematuria

Dip Stick

  • Nitrite test
  • Leukocyte esterase test

Urine C/S

  • Mid stream sample
  • Catheterization
  • Suprapubic aspiration

Sensitivity & Specificity of rapid urine tests

Pediatric Nephrology 2011: 26: 1967-1976

  WBC Gram stain LE Nitrite Either LE or nitrite Both LE and nitrite
Sensitivity 74% 91% 79% 49% 88% 45%
Specificity 86% 96% 87% 98% 79% 98%

Leukocytosis Neutrophilia Increased CRP

rapid urine tests

UTI (Urinary Tract Infection)



  • Proper history and physical examination must
  • In a febrile child always do urine routine either by dipstick or send it to lab
  • For urine culture proper instructions must and better to send child to lab
  • Recurrent UTI definitely needs a thought and further analysis
  • Avoid delay of 48-hours of observation period in febrile child
  • Avoid starting antibiotic before sending urine routine and culture in a febrile child
  • Avoid postponing sonography and other investigations

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