Page 274 - HPP ANTIMICROBIAL GUIDELINE 2018

URINARY TRACT INFECTIONS

Suggested Treatment
Infection/Condition Comments
Preferred Alternative

Acute cystitis Cefuroxime 30 mg/kg IV q12h Nitrofurantoin 6mg/kg/day PO q6h Amoxicillin/clavulanate and trimethoprim are
E. coli (max 1gm/day) PO for 5-7 days (max 100mg) for 5-7days alternative for acute cystitis
Proteus spp Note: single dose of antibiotic therapy not
recommended. Empirical antibiotic choices guided by
local organism resistant pattern

Acute pyelonephritis Cefotaxime 50 mg/kg IV q8h Cefuroxime 50 mg/kg IV q8h Culture should be repeated within
E. coli 48hours. Antibiotic may need to be changed
Proteus spp OR OR according to sensitivity

Ceftriaxone 50-75 mg/kg q24h Gentamicin 5mg/kg IV q24h
Suggest to continue intravenous antibiotic until child
is afebrile for 3-4 days and then switch to
appropriate oral therapy after culture results e.g.
cefuroxime, for total of 10-14 days if susceptible

Prophylaxis for UTI Trimethoprim 1-2mg/kg PO Nitrofurantoin 1-2mg/kg PO nocte Antibiotic prophylaxis should not be routinely
For infants and children nocte (long term use may associated recommended in children with first-time UTI
rd
with recurrent UTI with chronic pulmonary or hepatic (refer paediatric protocols 3 edition)
reaction)
MCUG prophylactic antibiotics:
• 3 days oral antibiotics with MCUG taking
place on the 2 day (uncomplicated)
nd
• Gentamicin IV just before procedure

References:
1. The Cochrane Database of Systematic Reviews
2. NICE Guidelines: Urinary tract infection: diagnosis, treatment and long term management of urinary tract infection in children 2007
3. UTI Clinical Practise Guideline, Paediatrics 2011
4. Frank Shann (2014) Drug doses, Intensive Care Unit Royal Children’s Hospital, Australia 16 Edition.
th

HPP AMG Urinary Tract Infections 132