The Committee on Quality Improvement of the American Academy of Pediatrics developed …

• Abstract
• Development of the Parameter
• Diagnosis (Recommendations 1 through 5)
• Treatment (Recommendations 6 through 10)
• Evaluation: Imaging (Recommendation 11)
• Areas for Future Research
• Summary
• References
• Figures
• Tables

Biology Articles » Medicine » Pediatrics » The AAP Practice Parameter on Urinary Tract Infections in Febrile Infants and Young Children » Evaluation: Imaging (Recommendation 11)

Evaluation: Imaging (Recommendation 11)

- The AAP Practice Parameter on Urinary Tract Infections in Febrile Infants and Young Children

Evaluation: Imaging (Recommendation 11)

Recommendation 11: Infants and young children two months to two years of age with UTI who do not demonstrate the expected clinical response within two days of antimicrobial therapy should undergo ultrasonography; voiding cystourethrography (VCUG) or radionuclide cystography (RNC) is strongly encouraged to be performed at the earliest convenient time. Infants and young children who have the expected response to antimicrobial treatment should have a sonogram at the earliest convenient time; VCUG or RNC is strongly encouraged to be performed at the earliest convenient time (strength of evidence: fair).

Imaging of the urinary tract is recommended for every febrile infant, boy or girl, with a first UTI to identify abnormalities that predispose to renal damage.

Ultrasonography is used to detect dilatation from obstruction. VCUG is generally recommended to identify and grade reflux. The subcommittee acknowledged that the evidence related to treating reflux (e.g., prophylactic antibiotic) is limited but was impressed with the relationship of renal scarring to reflux; therefore, VCUG (or RNC) was "strongly encouraged." (Note: This decision was not reflected accurately in the parameter but was clarified in an erratum.¹)