URINARY TRACT INFECTIONS

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Infection/Condition and Likely Organism

Suggested Treatment

Comments

Preferred

Alternative

Urinary Tract Infection (UTI) Escherichia coli

Proteus spp.

Klebsiella spp.

Enterobacter spp.

0-2 months old:

Ampicillin 50mg/kg/dose IV

<1week of age: q12h

>1week of age: q8h

PLUS

Gentamicin 5mg/kg/dose IV

< 30 weeks of CGA: q48h

> 30-34 week of CGA: q36h

≥ 35 week CGA: q24h

 

>2 months old:

Uncomplicated UTI Cefixime 8-10mg/kg/day in 2 divided doses

OR

Cotrimoxazole (Trimethoprim 8mg/kg) In 2 divided doses

0-2 months old: Cefotaxime 50mg/kg/ dose q8h

>2 months old:

Complicated UTI

Cefotaxime 100-150mg/kg/day IV in 3 divided doses (max. 8gm/day)

OR

Ceftriaxone 100mg/kg

AND/OR

Gentamicin 5mg/kg/dose IV daily

Duration: 10-14 days.

>2 months old:

Duration: 7-14 days.

Switch to oral therapy when improving and able to tolerate oral therapy.

Prophylaxis for UTI for infants and children with recurrent UTI

Trimethoprim 1-2mg/kg PO at night

Nitrofurantoin 1-2mg/kg at night

OR

Cephalexin 10mg/kg/ dose at night

 
References
  1. American Academy of Paediatrics. Committee on Infectious Diseases. Red Book: Report of the Committee on Infectious Diseases (2018).
  2. National Antimicrobial Guideline, Third Edition. Petaling Jaya: Ministry of Health, Malaysia; 2019
  3. NICE Guidelines: Urinary tract infection: diagnosis; treatment and long term management of urinary tract infection in children 2007. Last update 2017.
  4. The Sanford guide to antimicrobial therapy 2018.
  5. UTI Clinical Practice Guideline, Pediatrics 2011.