Urine dipstick
Urine testing strategies for Infants less than 3 months
All infants younger than 3 months with suspected UTI should be referred to paediatric specialist care and a urine sample should be sent for urgent microscopy and culture. These infants should be managed in accordance with the recommendations for this age group in Fever in under 5s [4]. Do not use a urine dipstick to guide management of possible UTI in this age group.
Urine-testing strategies for infants and children 3 months or older but younger than 3 years
Use dipstick testing for infants and children 3 months or older but younger than 3 years with suspected UTI [1].
| Leukocyte Positive | Leukocyte Negative | |
| Nitrite Positive | Start antibiotic, send urine culture | Start antibiotic, send urine culture |
| Nitrite Negative | Start antibiotic, send urine culture | No antibiotic. Do not send urine culture (unless meets additional criteria) |
Urine-testing strategies for children 3 years or older
Use dipstick testing for children over 3 years with suspected UTI [1].
| Leukocyte Positive | Leukocyte Negative | |
| Nitrite Positive | Treat as UTI Send urine culture if high/intermediate risk of serious illness and/or history of previous UTI | Treat as UTI if fresh sample Send urine culture |
| Nitrite Negative | Only treat as UTI if good clinical evidence of such. Send urine culture NB May represent infection outside of urinary tract. | No UTI Do not send urine culture |