Revised AAP Guideline on UTI in Febrile Infants and Young Children.

In 2011, the American Academy of Pediatrics released a revision of its 1999 clinical practice guideline on urinary tract infections in febrile infants and young children two to 24 months of age. The new clinical practice guideline has several important updates based on evidence generated over the past decade. The updated guideline includes clinical criteria for collecting urine specimens. Diagnosis now requires evidence of infection from both abnormal urinalysis results and positive urine culture results (the criterion for a positive culture has been reduced from at least 100,000 colony-forming units per mL to at least 50,000 colony-forming units per mL). Oral treatment now is considered to be as effective as parenteral treatment. Renal and bladder ultrasonography is still recommended, but the biggest change in the current guideline is that routine voiding cystourethrography is no longer recommended after the first urinary tract infection. Follow-up is based on evaluating children for urinary tract infection during subsequent febrile episodes, rather than routinely performing repeat urine cultures.