UTI in Children
Antimicrobial prescribing: NHS Forth Valley
Child <3 months: refer urgently for assessment.
Child ≥ 3 months: use positive nitrite to guide.
If starting antibiotics - send pre-treatment Clean Catch Urine.
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
Commence one of following antibiotic options if indicated:
Trimethoprim
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
3 days
Cefalexin
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
3 days
Nitrofurantoin
3 months to 11 years: 750 micrograms/kg QDS
12 to 15 years: 50mg QDS
3 days
Change to different antibiotic above if there is no improvement in UTI symptoms after 48hr.
If urine culture shows resistance to an antibiotic commenced - change to antibiotic reported as sensitive (preferably one of options listed here)