Observational studyThe British journal of general practice : the journal of the Royal College of General Practitioners2015
Childhood urinary tract infection in primary care: a prospective observational study of prevalence, diagnosis, treatment, and recovery.
Observational study in The British journal of general practice : the journal of the Royal College of General Practitioners, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Diagnostic value of biomarkers for paediatric urinary tract infections in primary care: systematic review and meta-analysis.BMC family practice · 2021Pooled it
- Clinical Features for the Diagnosis of Pediatric Urinary Tract Infections: Systematic Review and Meta-Analysis.Annals of family medicinePooled it
- Ultrasonographic evaluation of urinary tract morbidity in school-aged and preschool-aged children infected with Schistosoma haematobium and its evolution after praziquantel treatment: A randomized controlled trial.PLoS neglected tropical diseases · 2017Trial
- Pediatric Urinary Antimicrobial Resistance Patterns in a Tertiary Hospital of Northern Greece: A Retrospective Laboratory-Based Surveillance Study.Antibiotics (Basel, Switzerland) · 2026Article
- Clinician and parent views on urine collection in precontinent children in the UK: a qualitative interview study.BMJ open · 2024Article
- Antibiotic Use for Common Infections in Pediatric Emergency Departments: A Narrative Review.Antibiotics (Basel, Switzerland) · 2023Review
- Article
- Long-term outcomes of urinary tract infection (UTI) in Childhood (LUCI): protocol for an electronic record-linked cohort study.BMJ open · 2019Article
- The Need for Improved Detection of Urinary Tract Infections in Young Children.Frontiers in pediatrics · 2017Article
- Article
- RCGP Research Paper of the Year 2015: strong messages for clinical care in all six research categories.The British journal of general practice : the journal of the Royal College of General Practitioners · 2016Article
- Improving the Diagnosis and Treatment of Urinary Tract Infection in Young Children in Primary Care: Results from the DUTY Prospective Diagnostic Cohort Study.Annals of family medicine · 2016Article
- Nappy pad urine samples for investigation and treatment of UTI in young children: the 'DUTY' prospective diagnostic cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2016Article
- Childhood UTI.The British journal of general practice : the journal of the Royal College of General Practitioners · 2015Article
- Child health care in general practice: priorities for education and practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2015Article
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17 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundThe prevalence of targeted and serendipitous treatment for, and associated recovery from, urinary tract infection (UTI) in pre-school children is unknown.
aimTo determine the frequency and suspicion of UTI in children who are acutely ill, along with details of antibiotic prescribing, its appropriateness, and whether that appropriateness impacted on symptom improvement and recovery. DESIGN AND
settingProspective observational cohort study in primary care sites in urban and rural areas in England and Wales.
methodSystematic urine sampling from children aged <5 years presenting in primary care with acute illness with culture in NHS laboratories.
resultsOf 6079 children's urine samples, 339 (5.6%) met laboratory criteria for UTI and 162 (47.9%) were prescribed antibiotics at the initial consultation. In total, 576/7101 (8.1%) children were suspected of having a UTI prior to urine sampling, including 107 of the 338 with a UTI (clinician sensitivity 31.7%). Children with a laboratory-diagnosed UTI were more likely to be prescribed antibiotics when UTI was clinically suspected than when it was not (86.0% versus 30.3%, P<0.001). Of 231 children with unsuspected UTI, 70 (30.3%) received serendipitous antibiotics (that is, antibiotics prescribed for a different reason). Overall, 176 (52.1%) children with confirmed UTI did not receive any initial antibiotic. Organism sensitivity to the prescribed antibiotic was higher when UTI was suspected than when treated serendipitously (77.1% versus 26.0%; P<0.001). Children with UTI prescribed appropriate antibiotics at the initial consultation improved a little sooner than those with a UTI who were not prescribed appropriate antibiotics initially (3.5 days versus 4.0 days; P = 0.005).
conclusionOver half of children with UTI on culture were not prescribed antibiotics at first presentation. Serendipitous UTI treatment was relatively common, but often inappropriate to the organism's sensitivity. Methods for improved targeting of antibiotic treatment in children who are acutely unwell are urgently needed.
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