The Pharmaceutical Journal
Vol 279 No 7466 p198
25 August 2007

This article
Reprint   Photocopy

  Acrobat Reader

News summary

NICE issues guidance on managing urinary tract infection in children

Children from three months of age with acute pyelonephritis (upper urinary tract infection) should be treated with an oral antibiotic with low resistance patterns, such as a cephalosporin or co-amoxiclav, for seven to 10 days, the National Institute for Health and Clinical Excellence sets out in a new clinical guideline, developed in conjunction with the National Collaborating Centre for Women’s and Children’s Health.

If such children are not suitable for oral treatment, they should be treated with an intravenous antibiotic, such as cefotaxime or ceftriaxone, for two to four days, followed by oral antibiotics for a total period of 10 days.

Children three months of age or older with cystitis (lower urinary tract infection) should be treated with oral antibiotics, selected using locally developed guidance, for three days. NICE suggests trimethoprim, nitrofurantoin, amoxicillin or a cephalosporin as suitable options. It recommends that parents be advised to take their child to be reassessed if they are still unwell after 24 to 48 hours of treatment.

Infants younger than three months should be referred immediately to a paediatric specialist if urinary tract infection is suspected. In terms of prophylaxis, NICE does not recommend routine antibiotic cover following a first-time urinary tract infection.

NICE has also released a clinical guideline on the diagnosis and management of chronic fatigue.