Update and summary of the EAU/ESPU paediatric guidelines on urinary tract infection in children.
Published by European Association of Urology (EAU) and the European Society for Paediatric Urology (ESPU)
Summary
AI-generatedThis clinical summary outlines the 2025 EAU/ESPU guideline updates on pediatric urinary tract infections (UTIs). It details diagnostic classifications, urine collection and urinalysis methods, recommendations for renal and bladder ultrasound, targeted antimicrobial selection based on local sensitivity, and various methods for preventing UTI recurrence.
Key Takeaways
- 1Urinary tract infections (UTIs) represent the most common bacterial infections in children.
- 2Escherichia Coli (E. Coli) remains the leading causative organism, though other bacteria and multi-drug resistant strains are increasing in prevalence.
- 3Microscopic urinalysis is recommended following a positive dipstick test.
- 4A renal and bladder ultrasound is generally recommended after an initial febrile UTI, with additional investigations tailored based on patient and infection characteristics.
- 5Cornerstone of management is prompt, targeted antimicrobial therapy matched to local sensitivity patterns and adjusted according to sensitivity testing.
- 6Recurrence prevention strategies include chemoprophylaxis, non-antibiotic prophylaxis, and treating underlying conditions like phimosis, bladder-bowel dysfunction, and lower urinary tract dysfunction.
What's New in This Version
The 2025 guidelines update compiles and integrates evidence from a structured literature review covering publications from the previous 2021 update up to February 20, 2024.
Key Recommendations
Diagnosis
- 1
Microscopic urinalysis is recommended after a positive dipstick test.
Diagnostic
Diagnostic evaluation
- 2
A renal and bladder ultrasound is generally recommended after an initial febrile UTI.
Diagnostic imaging
Management
- 3
The cornerstone of UTI management is prompt antimicrobial therapy, with the administration route chosen based on several variables.
Therapeutic - 4
The antimicrobial agent should be chosen based on local antimicrobial sensitivity patterns, and adjusted according to sensitivity-testing.
Therapeutic
Prevention
- 5
Interventions can be considered to prevent UTI recurrence including chemoprophylaxis, non-antibiotic prophylaxis, and treatment of phimosis, bladder-bowel dysfunction and lower urinary tract dysfunction.
Prevention
Scope & Objectives
Clinical Topic
Urinary tract infection in children
Objectives
To provide a practical approach for both diagnosis and management of urinary tract infections (UTI) and highlight the 2025 update of the EAU/ESPU Guidelines on UTI in children.
Target Patient Population
Children
Diagnostic Criteria
Urinalysis is conducted on urine samples collected via bag, clean catch, catheterization, or suprapubic aspiration using dipstick, microscopy, or flow imaging. Microscopic urinalysis is recommended after a positive dipstick. For further investigation, a renal and bladder ultrasound is recommended after an initial febrile UTI, with additional tests guided by patient and infection characteristics.
Patient Criteria & Setting
Therapeutic Area
UrologyGuideline Scope
Special Populations
Safety & Contraindications
Monitoring Guidance
Additional investigations beyond the standard renal and bladder ultrasound should be considered based on the individual patient and infection characteristics.
Authors & Contributors
Guideline Features
Learning Context
Difficulty
intermediate
Learning Paths