Authors' objectives:

This Effective Health Care bulletin summarises the research evidence on the diagnosis of urinary tract infection (UTI) in children under five years of age.

Authors' recommendations: Urinary tract infection (UTI) is common in children under five. Children who are misdiagnosed can either fail to receive appropriate treatment or receive unnecessary treatment and investigation. All of the tests commonly used for the diagnosis of UTI are carried out on urine samples. A dipstick test which is positive for both nitrite and leukocyte esterase (LE) indicates a very high likelihood of a UTI. Dipstick negative for LE and nitrite or microscopic analysis negative for pyuria and bacteriuria of a clean voided urine (CVU), bag or nappy/pad specimen can be used to rule out UTI, avoiding the need for further investigation for UTI. Acute Tc-99m-DMSA remains the reference standard test for the localisation of UTI. In the absence of evidence of any effect on patient outcome, universal imaging (e.g. micturating cystourethrography (MCUG) for reflux or dimercaptosuccinic acid scintigraphy (DMSA) for renal scarring) cannot be justified; referral should be on an individual patient basis.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.york.ac.uk/inst/crd/ehcb_em.htm

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: University of York

Contact Address: University of York, York, Y01 5DD, United Kingdom. Tel: +44 1904 321040, Fax: +44 1904 321041,

Contact Name: crd@york.ac.uk

Contact Email: crd@york.ac.uk

Copyright: Centre for Reviews and Dissemination