An American response to the Italian guideline on urinary tract infections in young children
Year: 2012
Type: article
Abstract: This issue of Acta Pediatrica includes the Italian Society of Pediatric Nephrology's recommendations for the diagnosis, treatment and follow-up of febrile urinary tract infections in young children (1).These recommendations are similar in many ways to the American Academy of Pediatrics' (AAP) 'Clinical Practice Guideline for the Diagnosis and Management of the Initial Urinary Tract Infection (UTI) in Febrile Infants and Children 2-24 Months' (2), published in Pediatrics in September 2011.In both guidelines, a less aggressive approach is recommended for treatment, evaluation and follow-up of febrile infants experiencing a first Urinary Tract Infection (UTI).This new approach includes recommendation for oral antibiotics for most infants and no recommendation for routine voiding cystourethrography (VCUG).However, the guidelines address children of different ages and differ in important ways regarding diagnostic approaches and imaging evaluation.The Italian guideline applies to children from 2 months to 3 years of age.The AAP guideline applies only to children 2 months to 2 years of age.Both guidelines acknowledge a 5% risk of UTI among young febrile children, but the Italian guideline offers no specific guidance on which children do not need to have their urine examined.The AAP guideline addresses specific clinical criteria the clinician may use to rule out UTI without further testing.When urine testing is needed, the guidelines differ on how the specimen should be obtained.Although both guidelines conclude that suprapubic aspiration and transurethral
Source: Acta Paediatrica
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W1579205079