Clinical Practice Guideline for the Diagnosis and Treatment of Urinary Tract Infection in Children From 8 Days to 5 Years of Age
In brief
Updated pediatric UTI guideline offers eight recommendations, mostly conditional
The guideline covers children 8 days to 5 years old, offering eight key recommendations: two strong and six conditional, based on low- to very low-certainty evidence. It also includes four good-practice statements on evaluation, antibiotics, imaging, prevention and bladder-bowel dysfunction; clinicians should note that much of the supporting evidence remains uncertain.
- Journal
- Pediatrics (Q1)
- Published
- 28 September 2026
- Study design
- Practice guideline / consensus
- Evidence level
- Level 1, High (CEBM 1c)
- Authors
- Brian K Alverson, David S Hains, Stephen M Downs, Rana E El Feghaly, Catherine S Forster, Shabnam Jain, et al.
- PMID
- 42803578
- DOI
- 10.1542/peds.2026-078565
Why clinicians should know about it
- Picked for Pediatrics and Child Health (top studies of the week, 4 October 2026): Clinical practice guideline for pediatric UTI
Abstract
Urinary tract infection (UTI) is one of the most common bacterial infections in infants and young children, with a prevalence of 7% in infants with fever. This clinical practice guideline (CPG) provides an update of the literature and clinical recommendations of the 2011 American Academy of Pediatrics (AAP) CPG on diagnosing and managing UTI in infants and children. It is designed to provide guidance for pediatricians and other pediatric clinicians on the diagnosis and management of UTIs in infants and children 8 days to 5 years of age and is intended for use in children with low medical complexity across a variety of settings. The CPG is accompanied by 3 technical reports to further elucidate the data that guided the development of recommendations and to establish criteria for the diagnosis of UTI. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the certainty of the evidence and formulate recommendations and good practice statements, including GRADE evidence-to-decision frameworks, which were reviewed by internal and external contributors. The CPG provides 8 Key Action Statements (2 strong and 6 conditional clinical recommendations, ranging from low to very low certainty of evidence) and 4 Good Practice Statements regarding medical evaluation of suspected UTI, management of UTI specific to antibiotic treatment, and imaging modalities and prevention strategies for structural abnormalities, including vesicoureteral reflux, and bowel and bladder dysfunction evaluation and treatment.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.