Oct 15, 2026 · 22 min · 12 segments
Send us Fan Mail How long should you treat a UTI in an 8-day-old, and when do you really need a VCUG? On this Journal Club, Daphna breaks down the…
And why? Why are we, why are we excited about it? And the AAP, just this month, uh, of October, um, released a new clinical practice guideline for the diagnosis and treatment of urinary tract infection in children from eight days to five years of age.
Um, so I will also highlight before I forget that this clinical practice guideline is also accompanied by [laughs] three additional guidelines, uh, and, uh, practice technological parameters.
What I'm going to try and do is really just highlight what is new and different, and then of course, just the key action statements for everybody.
Um, but I think, uh, it rec- they recognized that there was a gap in these babies that are younger than the two-month mark that, uh-
So we're very thankful that they've been thinking about us, uh, neonatal professionals.
It's 70, I don't know, 75 pages long, 78 pages long, um, chock full of really good background information and data on risks for urinary tract infection, uh, anomalies in, seen in urinary tract infections.
So I think if you've got a rainy afternoon, everybody should read this, I think, from cover to cover, uh, to really understand how we've gotten to the guidelines, uh, the way that we have.
And, um, in 2011, those guidelines really focused on the two to 24-month age group of febrile infants, um, with, uh, really no anatomic problems.
Um, and the two t- the, the current guidelines now focus from eight days to five years, so also on the upper end of those, um, kind of just, uh, entering school-age kids, the little toddlers.
And, um, it focuses on the medically non-complex children, but I think gives us a lot more data on babies who are medically complex, or children who are medically complex, um, and potentially have, uh, renal anomalies.
Uh, in 2011, it was really about febrile, uh, infants, uh, or young children with no apparent source.
And now, um, in the 2026, they still don't give us a lot of specification in that eight days, uh, so it's still probably febrile infants between eight, uh, days and two months.
But the two to 24 months really fevers without a source, and then it includes two to five years, um, uh, children who may not have fever but may have symptoms consistent with a UTI.
Really the timing of evaluation, uh, again, just being more explicit that we should consider UTI even in the first 72 hours of fever, knowing that benefit of treatment, the sooner we start, the better, less implications for kidneys long term.
How are we diagnosing them? Still, uh, the clean catch urine is not, uh, felt to be the best, uh, method.
And why? Why are we, why are we excited about it? And the AAP, just this month, uh, of October, um, released a new clinical practice guideline for the diagnosis and treatment of urinary tract infection in children from eight days to five years of age.
Um, so I will also highlight before I forget that this clinical practice guideline is also accompanied by [laughs] three additional guidelines, uh, and, uh, practice technological parameters.
What I'm going to try and do is really just highlight what is new and different, and then of course, just the key action statements for everybody.
Um, but I think, uh, it rec- they recognized that there was a gap in these babies that are younger than the two-month mark that, uh-
So we're very thankful that they've been thinking about us, uh, neonatal professionals.
It's 70, I don't know, 75 pages long, 78 pages long, um, chock full of really good background information and data on risks for urinary tract infection, uh, anomalies in, seen in urinary tract infections.
So I think if you've got a rainy afternoon, everybody should read this, I think, from cover to cover, uh, to really understand how we've gotten to the guidelines, uh, the way that we have.
And, um, in 2011, those guidelines really focused on the two to 24-month age group of febrile infants, um, with, uh, really no anatomic problems.
Um, and the two t- the, the current guidelines now focus from eight days to five years, so also on the upper end of those, um, kind of just, uh, entering school-age kids, the little toddlers.
And, um, it focuses on the medically non-complex children, but I think gives us a lot more data on babies who are medically complex, or children who are medically complex, um, and potentially have, uh, renal anomalies.
Uh, in 2011, it was really about febrile, uh, infants, uh, or young children with no apparent source.
And now, um, in the 2026, they still don't give us a lot of specification in that eight days, uh, so it's still probably febrile infants between eight, uh, days and two months.
But the two to 24 months really fevers without a source, and then it includes two to five years, um, uh, children who may not have fever but may have symptoms consistent with a UTI.
Really the timing of evaluation, uh, again, just being more explicit that we should consider UTI even in the first 72 hours of fever, knowing that benefit of treatment, the sooner we start, the better, less implications for kidneys long term.
How are we diagnosing them? Still, uh, the clean catch urine is not, uh, felt to be the best, uh, method.
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