Swiss consensus recommendations on urinary tract infections in children
CH-Guideline · 2020 · Switzerland
Source and licence
- Authors
- Michael Buettcher, Johannes Trueck, Anita Niederer-Loher et al.
- Title
- Swiss consensus recommendations on urinary tract infections in children
- Journal
- European Journal of Pediatrics, 2020
- Licence
- CC BY 4.0
- Changes
- Verbatim excerpts; formatting adapted
Full text retrieved 2026-10-27 from Europe PMC · PMC7886823
Licence statement of the original publication
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This page reproduces excerpts of the original publication; the original is authoritative. It has not been reviewed by a physician, does not state a recommendation of Medelix and does not replace medical advice. The guideline may have been updated since.
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Recommendations
Verbatim, with grade of recommendation or strength of consensus where given.
Micturition cystourethrogram
- We recommend performing MCUG only in the following circumstances: • CAKUT and/or dilatation of the urinary tract on ultrasound (an isolated mild dilatation of the renal pelvis (≤ 10 mm) is not an indication for further imaging) • Poor urine flow, e.g., posterior urethral valves [PUV] in boys, oliguria not due to dehydration, urinary retention • Infection with organisms other than E. coli • Failure to respond to treatment with suitable antibiotics within 48 h • Increased creatinine (according to age) or abnormal electrolytes (for example, hyponatremia and hyperkalemia with suspicion of secondary transient pseudohypoaldosteronism) or arterial hypertension • Recurrent pyelonephritis (2 or more episodes)
Abstract
The kidneys and the urinary tract are a common source of infection in children of all ages, especially infants and young children. The main risk factors for sequelae after urinary tract infections (UTI) are congenital anomalies of the kidney and urinary tract (CAKUT) and bladder-bowel dysfunction. UTI should be considered in every child with fever without a source. The differentiation between upper and lower UTI is crucial for appropriate management. Method of urine collection should be based on age and risk factors. The diagnosis of UTI requires urine analysis and significant growth of a pathogen in culture. Treatment of UTI should be based on practical considerations regarding age and presentation with adjustment of the initial antimicrobial treatment according to antimicrobial sensitivity testing. All children, regardless of age, should have an ultrasound of the urinary tract performed after pyelonephritis. In general, antibiotic prophylaxis is not recommended.
Conclusion: Based on recent data and in line with international guidelines, multidisciplinary Swiss consensus recommendations were developed by members of Swiss pediatric infectious diseases, nephrology, and urology societies giving the clinician clear recommendations in regard to diagnosis, type and duration of therapy, antimicrobial treatment options, indication for imaging, and antibiotic prophylaxis.
Contents of the original publication
The section headings of the original.
- Introduction
- Methods
- Aim
- Recommendation no. 1: Clinical suspicion of UTI
- Recommendation no. 2: Differentiation between upper and lower UTI
- Recommendation no. 3: Methods of urine collection
- Recommendation no. 4: Urine analysis and culture, additional laboratory testing
- Recommendation no. 5: Definition of a positive urine culture
- Recommendation no. 6: Treatment of UTI
- Switch to oral treatment
- Summary of treatment recommendations of all age groups
- Recommendation no. 7: Follow-up during the course of infection
- Recommendation no 8: The role and timing of urinary tract imaging in pyelonephritis
- Recommendation 9: Indications for long-term antibiotic prophylaxis
- Recommendation 10: Bladder-bowel dysfunction is a relevant risk factor for recurrent UTI (evidence quality: high; recommendation: strong)
- Recommendation 11: Surgical and endoscopic intervention should be considered in selected cases on an individual basis (evidence quality: moderate; recommendation: weak)
- Compliance with ethical standards
- Ethical approval
- Informed consent
- Contributor Information
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