In this section
Children with suspected UTI should have a urine sample collected; dipstick and microscopy screening can guide initial management. Check culture results after 24hrs to confirm or adjust management as appropriate.
Urine samples should be collected prior to starting antibiotics (unless the child is seriously unwell and requires immediate IV therapy)
The perineal/genital area should be cleaned with saline-soaked gauze for 10 seconds before collecting midstream or clean catch urine.
Midstream urine (MSU): preferred method for toilet-trained children who can void on request – contamination rate 25%
Clean catch: appropriate for pre-continent children who cannot void on request, but are not seriously unwell (yield may be improved by gently rubbing child’s suprapubic area with gauze soaked in cold fluid, see
urine tests) - contamination rate 25%
Suprapubic aspirate (see
SPA): gold standard – contamination rate 1%
In/out catheter: useful if there is little urine in the bladder, such as after failed clean catch or SPA (discard first few drops of urine if possible to reduce contamination) – contamination rate 10%
Bag urine: not recommended for culture due to high false positive rates – contamination rate 50%
Microscopy and Culture
Trimethoprim 4mg/kg BD (max 150mg) (only tablets generally available)
Trimethoprim/sulfamethoxazole (8mg/40mg per ml) 0.5ml/kg (max 20ml) BD (should be avoided in infants
< 6 weeks old)
Cephalexin 25mg/kg (max 500mg) tds
Any child requiring care beyond the level of comfort of the treating hospital
advice and paediatric or neonatal ICU transfers, call the Paediatric Infant
Perinatal Emergency Retrieval (PIPER) Service: 1300 137 650.
Tolerating oral fluids and antibiotics
UTI Kids Health Info fact sheet
Urine Tests Kids Health Info fact sheet
Interpreting urine test results:
Last updated November, 2017