UTI in Children

PHE URINE

CKS

NICE

Child <3 months: refer urgently for assessment.

Child ≥ 3 months: use positive nitrite to guide.

Start antibiotics: also send pre-treatment MSU.

Imaging: only refer if child <6 months, or recurrent or atypical UTI.

Upper UTI - refer to paediatrics to: obtain urine sample, assess for signs of systemic infection; consider systemic antimicrobials

Drug details

Lower UTI:

Trimethoprim

or Nitrofurantoin

or Cefalexin

If sensitive and no other suitable option: Cefuroxime axetil

Child

3 to 5 months: 4 mg/kg (maximum 200mg per dose) or 25mg BD

6 months to 5 years, 4mg/kg (maximum 200mg per dose) or 50mg BD

6 to 11 years, 4mg/kg (maximum 200mg per dose) or 100mg BD

12 to 15 years, 200mg BD

Child

3 months to 11 years: 750 micrograms/kg QDS

12 to 15 years: 50mg QDS or 100mg MR BD

Child

3 to 11 months: 12.5mg/kg or 125mg BD

1 to 4 years: 12.5mg/kg BD or 125mg TDS

5 to 11 years: 12.5mg/kg BD or 250mg TDS

12 to 15 years: 500mg BD or TDS

Child

Weight <40kg: 15mg/kg BD (max. per dose 250mg).
Weight ≥40kg: 250mg BD

3 days

Upper UTI: Consider referral to Paediatrics

Co-amoxiclav

Alternative:Cefalexin

If sensitive and no other suitable option:Cefuroxime axetil

Child

1 to 11 months: 0.25ml/kg of 125/31 suspension TDS

1 to 5 years: 5ml of 125/31 suspension TDS or 0.25ml/kg of 125/31 suspension TDS

6 to 11 years: 5ml of 250/62 suspension TDS or 0.15ml/kg of 250/62 suspension TDS

12 to 17 years: 250/125mg TDS or 500/125mg TDS

1 month to 11 years: 25mg/kg BD to QDS (maximum 1 g per dose QDS)

12 to 15 years: 1.5 g TDS or QDS

Child

Weight <40kg: 15mg/kg BD (max. per dose 250mg).
Weight ≥40kg: 250mg BD

7-10  days