What are the AAP guidelines for the follow-up of infants with a urinary tract infection (UTI)?

Updated: Mar 19, 2019
  • Author: Donna J Fisher, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

The AAP guidelines for the followup of these patients can be summarized as follows [3] :

  • After 7 days of antimicrobial therapy, close clinical follow-up monitoring is required to help ensure that recurrent infections can be promptly diagnosed and treated

  • Ultrasonograms of the kidneys and bladder should be obtained in order to detect anatomic abnormalities

  • The routine use of VCUG after the first UTI is not recommended, since data do not support the use of antimicrobial prophylaxis to prevent recurrent febrile UTI in infants unless they have VUR above grade 4,

  • VCUG is indicated if ultrasonograms of the kidney and bladder reveal hydronephrosis, scarring, or other signs that high-grade VUR or obstructive uropathy may be present

  • VCUG should be performed if febrile UTI recurs, even if previous ultrasonographic findings were unremarkable


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