Version October 2024
This algorithm summarizes our suggested approach to the choice of empiric antibiotic to treat UTI in children older than 1 month and less than 2 years of age, based on fever and allergy. This algorithm is intended for use in conjunction with additional UpToDate content. For additional details, including the evidence supporting the efficacy of these antibiotics, refer to UpToDate topics on the management of UTI in children.
Allergy refers to IgE-mediated reactions. Family history of antibiotic allergy and gastrointestinal upset are not considered allergies.
All children with suspected UTI should have urine obtained for culture prior to initiation of empiric antibiotics.IgE: immunoglobulin E; IV: intravenous; TMP-SMX: trimethoprim-sulfamethoxazole; UTI: urinary tract infection.
* Use a third-generation cephalosporin instead of cephazolin in hospitalized patients when a cephalosporin has been used within 2 months and/or the local resistance of Escherichia coli to first-generation cephalosporins is high (ie, ≥15%).
¶ Provided that the local resistance of E. coli to first-generation cephalosporins in the specific community is not high (ie, not ≥15%). If it is high, an alternative antibiotic should be chosen based on local resistance patterns.Do you want to add Medilib to your home screen?
