For children between 2 and 24 months of age, the relevant high points for EM:
– Don’t use bag urines. Catheterization or suprapubic aspiration is the only acceptable way to make a diagnosis. However, if you’re stuck, and you have to use a bag, a completely normal bag urine is diagnostic.
– Send a culture to definitively establish the diagnosis based on pyuria and/or bacteruria and the presence of at least 50,000 CFU/mL of a uropathogen.
– Oral antibiotic recommendations listed include amoxicillin-clavulanate, trimethoprim-sulfamethoxazole, and a range of oral cephalosporins for at least 7 days. They do not have any evidence to compare 7, 10, and 14 day courses. Nitrofurantoin is not appropriate.
Nothing terribly earthshaking – seems all pretty reasonable.
“Urinary Tract Infection: Clinical Practice Guideline for the Diagnosis and Management of the Initial UTI in Febrile Infants and Children 2 to 24 Months.”
pediatrics.aappublications.org/content/early/2011/08/24/peds.2011-1330