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Patients and Family Resources

all patients and families resources







Resources in Evidence Repository and Individual Compendia

Bottom Line Recommendations

Clinical Pathway: Urinary tract infection in under 16s overview

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National Institute for Health and Care Excellence

This clinical pathway contains diagnosis and treatment information for persons under 16 with suspected urinary tract infection.

Clinical management of patients with moderate to severe COVID-19 - Interim guidance

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Government of Canada

Bottom Line Recommendations: Urinary Tract Infection

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Le Saux N, Neto G, TREKK Network

Bottom Line Recommendations for diagnosis and treatment of urinary tract infection. Version 1.1

Recommandations de Base: Infection Urinaire

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Le Saux N, Neto, G TREKK Network

Bottom Line Recommendations for diagnosis and treatment of urinary tract infections - French. Version 1.1.

Summary: Urinary tract infections in children

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Goilav B

This summary presents key diagnostic risk factors for urinary tract infections (UTIs) in children. The summary also covers diagnostic investigations and treatment algorithms for uncomplicated and complicated UTIs.

Clinical guidelines

Clinical Practice Guideline: Peripheral neurovascular checklist

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SicKids Division of Orthopaedic Surgery

Peripheral Neurovascular Checklist.

Clinical Practice Guideline: Urinary tract infection

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The Royal Children's Hospital Melbourne

These guidelines provide assessment and management information for children with urinary tract infections.

Clinical Practice Guideline: Urinary tract infection in under 16s: diagnosis and management

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National Institute for Health and Care Excellence

These guidelines contain diagnosis and treatment information for persons under 16 with suspected urinary tract infection.

Clinical Practice Guideline: Urinary tract infection in children and young people

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National Institute for Health and Care Excellence

This quality standard covers diagnosing and managing urinary tract infection in infants, children and young people (under 16). It includes new and recurrent infections of the upper or lower urinary tract. It describes high-quality care in priority areas for improvement.

Clinical Pathways: Urinary Tract Infection (UTI)

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Seattle Children's Hospital

These pathways contain diagnosis and treatment guidance for urinary tract infections in a range of patients (outpatients, inpatients) of different ages (infants, children and adolescents) and presentations (atypical and typical).

Clinical Practice Guideline: Reaffirmation of AAP Clinical Practice Guideline: The Diagnosis and Management of the Initial Urinary Tract Infection in Febrile Infants and Young Children 2-24 Months of Age

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Subcommittee on Urinary Tract Infection

This article reaffirms the 2011 American Academy of Pediatrics' Urinary Tract Infection Clinical Practice Guidelines and provides an updated review of the supporting evidence.

Clinical Practice Guideline: Urinary tract infection in infants and children: Diagnosis and management

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Robinson JL, Finlay JC, Lang ME, Bortolussi R; Canadian Paediatric Society, I...

The Canadian Paediatric Society practice statement focuses on the diagnosis and management of infants and children >2 months of age with an acute urinary tract infection and no known underlying urinary tract pathology or risk factors for a neurogenic bladder.

Clinical Practice Guideline: Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months

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Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improv...

These guidelines revise the American Academy of Pediatrics practice parameter regarding the diagnosis and management of initial urinary tract infections (UTIs) in febrile infants and young children.

Consensus statement: Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts consensus statement.

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Shen K, Yang Y, Wang T, et al.

This statement is based on the Novel Coronavirus Infection Pneumonia Diagnosis and Treatment Standards (the fourth edition) (National Health Committee) and other previous diagnosis and treatment strategies for pediatric virus infections. The present consensus statement summarizes current strategies on diagnosis, treatment, and prevention of 2019-nCoV infection in children.

Clinical Practice Guideline: Urinary tract infections in children: EAU/ESPU guidelines

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Stein R, Dogan HS, Hoebeke P, Kovara R, Nijman RJ, Radmayr C, Tekgl S, Europe...

These European Association of Urology/European Society for Pediatric Urology guidelines provide recommendations for the diagnosis, treatment, and imaging of children presenting with urinary tract infections.

Clinical Practice Guideline: Technical reportDiagnosis and management of an initial UTI in febrile infants and young children

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Finnell SM, Carroll AE, Downs SM; Subcommittee on Urinary Tract Infection

This report was developed to inform the revised, evidence-based, clinical guideline regarding the diagnosis and management of initial urinary tract infections in febrile infants and young children, 2 to 24 months of age, from the American Academy of Pediatrics Subcommittee on Urinary Tract Infection.

Summaries of systematic reviews

Cochrane Summary: Antibiotics for preventing infection in open limb fractures

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Gosselin, RA, Roberts, I & Gillespie, WJ

Objective: To review the evidence for the effectiveness of antibiotics in the initial treatment of open fractures of the limbs.

Cochrane Summary: Antibiotics for lower urinary tract infection in children

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Fitzgerald A, Mori R, Lakhanpaul M, Tullus K

Urinary tract infection (UTI) is one of the most common bacterial infections in infants and children. The most commonly presenting infection of the urinary tract is known as cystitis and in the majority of cases can be easily treated with a course of antibiotic therapy with no further complications. This review identified 16 studies investigating antibiotics for UTI in children. Results suggest that 10-day antibiotic treatment is more likely to eliminate bacteria from the urine than single-dose treatments; there was not enough data to draw conclusions about other treatment durations, or effectiveness of particular antibiotics. Although antibiotic treatment is effective for children with UTI, there are insufficient data to recommend any specific regimen.

Cochrane Summary: Long-term antibiotics for preventing recurrent urinary tract infection in children

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Williams G, Craig JC

Bladder and kidney infections (urinary tract infection - UTI) are common in children, especially girls. They cause an uncomfortable illness that can include vomiting, fever and tiredness. In some children kidney damage may occur, as can repeat illnesses. With repeated infections the risk of kidney damage increases. Some doctors prescribe long-term antibiotics to try to prevent infections recurring, but this may cause the child to be unwell in other ways, e.g. vomiting. This review of randomised controlled trials (RCTs) found evidence that long-term antibiotics did reduce the risk of more symptomatic infections but the benefit is small and must be weighed against the likelihood that future infections may be with bacteria that are resistant to the antibiotic given.

Cochrane Summary: Systemic corticosteroids for improving symptoms in children with acute middle ear infection

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Ranakusuma RW, Pitoyo Y, Safitri ED, Thorning S, Beller EM, Sastroasmoro S, D...

Objective: To assess the effects of systemic corticosteroids (oral or parenteral), with or without antibiotics, for AOM in children.

Cochrane Summary: Influenza vaccine for preventing acute otitis media (middle ear infection)

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Norhayati MN, Ho JJ, Azman MY

Objective: To assess the effectiveness of influenza vaccine in reducing the occurrence of acute otitis media in infants and children.

Cochrane Summary: Pain relievers for children with acute middle ear infection

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Sjoukes A, Venekamp RP, van de Pol AC, Hay AD, Little P, Schilder AG, Damoise...

Objective: Our primary objective was to assess the effectiveness of paracetamol (acetaminophen) or NSAIDs, alone or combined, compared with placebo or no treatment in relieving pain in children with AOM. Our secondary objective was to assess the effectiveness of NSAIDs compared with paracetamol in children with AOM.

DARE Quality-assessed Reviews: Absolute and relative accuracy of rapid urine tests for urinary tract infection in children: a meta-analysis

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Williams GJ, Macaskill P, Chan SF, Turner RM, Hodson E, Craig JC

This review assessed rapid urine tests for the diagnosis of urinary tract infection in children and concluded that no one test could identify all urinary tract infections without urine culture, but Gram-stain microscopy was the best single test. Dipstick tests should be considered positive if either leucocyte esterase or nitrite was positive. These conclusions are likely to be reliable.

DARE Quality-assessed Reviews: Systematic review of the diagnostic accuracy of C-reactive protein to detect bacterial infection in nonhospitalized infants and children with fever

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Sanders S, Barnett A, Correa-Velez I, Coulthard M, Doust J

The review assessed the accuracy of C-reactiveproteinfor diagnosingbacterial infectionsin febrile children and used robust reviewing and meta-analytic methods. The authors' conclusion that C-reactive protein provided moderate and independent information for ruling-in and ruling-out seriousbacterial infection, but cannot be used alone to exclude bacterial infection, is likely to be reliable.

DARE Quality-assessed Reviews: Rapid tests and urine sampling techniques for the diagnosis of urinary tract infection (UTI) in children under five years: a systematic review

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Whiting P, Westwood M, Watt I, Cooper J, Kleijnen J

This review concluded that for the diagnosis of urinary tract infection (UTI), dipstick negative for both leucocyte esterase and nitrite or negative microscopic analysis for pyuria of a clean voided urine, bag or nappy/pad specimen may be used to rule out UTI, and that combinations of positive tests could similarly be used to rule in UTI. These conclusions are likely to be reliable.

Cochrane Summary: Procalcitonin, C-reactive protein, and erythrocyte sedimentation rate for the diagnosis of acute pyelonephritis in children

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Shaikh N, Borrell JL, Evron J, Leeflang MM

In some children with urinary tract infection (UTI), the infection is localized to the bladder (lower urinary tract). In others, bacteria ascend from the bladder to the kidney (upper urinary tract). Only children with upper urinary tract involvement are at risk for developing permanent kidney damage. If non-invasive biomarkers could accurately differentiate children with lower urinary tract disease from children with upper urinary tract disease, treatment and follow-up could potentially be individualized. Accordingly, we examined the usefulness of three widely available blood tests (procalcitonin, C-reactive protein, erythrocyte sedimentation rate) in differentiating upper from lower urinary tract disease. We found 24 relevant studies of which 17 provided data for our primary outcome. Six studies (434 children) provided data for the procalcitonin test; 13 studies (1638 children) provided data for the C-reactive protein test, and six studies (1737 children) provided data for the erythrocyte sedimentation rate test. We found all three tests to be sensitive (summary sensitivity values ranged from 86% to 95%), but not very specific (summary specificity values ranged from 38% to 71%). None of the tests were accurate enough to allow clinicians to confidently differentiate upper from lower urinary tract disease.

Cochrane Summary: Are oral antibiotics as effective as a combination of injected and oral antibiotics for kidney infections in children?

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Strohmeier Y, Hodson EM, Willis NS, Webster AC, Craig JC

We wanted to find out if oral antibiotics were as effective as combined oral and injected antibiotics to treat children for kidney infection. This review updates our previous investigations published in 2003, 2005 and 2007. This review included evidence from 27 studies that involved 4452 children. The last literature search date was April 2014. This update included evidence from three new studies and from one study that was previously excluded. Review results suggested that children aged over one month with acute pyelonephritis can be treated effectively with oral antibiotics (cefixime, ceftibuten or amoxicillin/clavulanic acid) or with short courses (two to four days) of intravenous (IV) therapy followed by oral therapy. If IV therapy with aminoglycosides is needed, single daily dosing is safe and effective.

Cochrane Summary: Antibiotics for covert bacteriuria in children

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Fitzgerald A, Mori R, Lakhanpaul M

Covert bacteriuria occurs when bacteria are found in urine either during routine screening or incidentally during other investigations. Unlike urinary tract infections, children with covert bacteriuria do not appear to have symptoms at the time of diagnosis. There is uncertainty about whether antibiotic treatment can help to clear infection, reduce recurrence, or prevent kidney damage. Any harmful effects of providing treatment also need to be identified and understood. We identified three studies reporting the results on 460 girls. There was insufficient evidence about the harms and benefits of treatments to draw reliable conclusions, but it appears that antibiotic treatment is not likely to benefit children in the long term.

Cochrane Summary: Short courses of antibiotics (2-4 days) are as effective as longer treatment for bladder infections in children

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Michael M, Hodson EM, Craig JC, Martin S, Moyer VA

Bladder and kidney infections (urinary tract infections - UTI) are common in children. Bladder infections cause pain on passing urine and frequency of urination. Some children keep getting repeat bouts. Standard courses of antibiotics (7-10 days) are used to clear the infection. Shorter courses may reduce adverse effects and costs, but there has been concern that they might reduce the chances of clearing the infection and increase the risk of recurrence. A review of studies found that short courses of antibiotics (2-4 days) used for bladder infections are as effective as standard courses at clearing UTI, with no increase in recurrence.

Systematic reviews

Systematic Review: Meta-analysis to Determine Risk for Serious Bacterial Infection in Febrile Outpatient Neonates With RSV Infection

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Bonadio W, Huang F, Nateson S, Okpalaji C, Kodsi A, Sokolovsky S, Homel P

This study aimed to analyze a large group of febrile neonates 28 days or younger who received outpatient sepsis evaluation and nasopharyngeal aspirate antigen testing (NPAT) for respiratory syncytial viral (RSV) infection to determine whether there is a clinically significant association between viral study results and risk for serious bacterial infection (SBI: bacterial meningitis, bacteremia, urinary tract infection, bacterial enteritis).

Meta-analysis: Association of diagnostic criteria with urinary tract infection prevalence in bronchiolitis: a systematic review and meta-analysis

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McDaniel C, Ralston S, Lucas B, Schroeder AR

Objective: To conduct a systematic review and meta-analysis examining the prevalence of UTI in infants with bronchiolitis when positive UA results are incorporated into the UTI definition.

Cochrane Systematic Review: Monoclonal antibody for reducing the risk of respiratory syncytial virus infection in children

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Andabaka T, Nickerson JW, Rojas-Reyes MX, Rueda JD, Bacic Vrca V, Barsic B.

Objectives: To assess the effectiveness and safety of palivizumab prophylaxis compared with placebo, or another type of prophylaxis, in reducing the risk of complications (hospitalisation due to RSV infection) in high-risk infants and children. To assess the cost-effectiveness (or cost-utility) of palivizumab prophylaxis compared with no prophylaxis in infants and children in different risk groups.

Cochrane Systematic Review: Routine vitamin A supplementation for the prevention of blindness due to measles infection in children

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Bello S, Meremikwu MM, Ejemot-Nwadiaro RI, Oduwole O.

Objectives: To assess the efficacy of vitamin A in preventing blindness in children with measles without prior clinical features of vitamin A deficiency.

Cochrane Systematic Review: Antibiotics for preventing infection in open limb fractures

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Gosselin RA, Roberts I, Gillespie WJ

OBJECTIVES: To quantify the evidence for the effectiveness of antibiotics in the initial treatment of open fractures of the limbs.

Cochrane Systematic Review: Antibiotic adjuvant therapy for pulmonary infection in cystic fibrosis

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Hurley MN, Forrester DL, Smyth AR

OBJECTIVES: To determine if antibiotic adjuvants improve clinical and microbiological outcome of pulmonary infection in people with cystic fibrosis.

Cochrane Systematic Review: Neuraminidase inhibitors for the treatment of influenza infection in people with cystic fibrosis

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Jagannath VA, Asokan GV, Fedorowicz Z, Lee TW

OBJECTIVES: To assess the effects of neuraminidase inhibitors for the treatment of influenza infection in people with cystic fibrosis.

Cochrane Systematic Review: Drugs for treating Schistosoma mansoni infection

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Danso-Appiah A, Olliaro PL, Donegan S, Sinclair D, Utzinger J

OBJECTIVES: To evaluate the effects of antischistosomal drugs, used alone or in combination, for treating S. mansoni infection.

Cochrane Systematic Review: Antimicrobials for treating symptomatic non-typhoidal Salmonella infection

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Onwuezobe IA, Oshun PO, Odigwe CC

OBJECTIVES: To assess the efficacy and safety of giving antibiotics to people with NTS diarrhoea.

Cochrane Systematic Review: Antibiotics for treating lower urinary tract infection in children

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Fitzgerald A, Mori R, Lakhanpaul M, Tullus K

OBJECTIVES: This review aims to summarise the benefits and harms of antibiotics for treating lower UTI in children.

Cochrane Systematic Review: Short versus standard duration oral antibiotic therapy for acute urinary tract infection in children

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Michael M, Hodson EM, Craig JC, Martin S, Moyer VA

OBJECTIVES: The objective of this review was to assess the benefits and harms of short-course (2-4 days) compared to standard duration (7-14 days) oral antibiotic treatment for acute UTI in children.

Cochrane Systematic Review: Antibiotic prophylaxis for preventing burn wound infection

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Barajas-Nava LA, Lpez-Alcalde J, Roqu i Figuls M, Sol I, Bonfill Cosp X

OBJECTIVES: To assess the effects of antibiotic prophylaxis on rates of burn wound infection.

Cochrane Systematic Review: Disposable surgical face masks for preventing surgical wound infection in clean surgery

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Lipp A, Edwards P

OBJECTIVES: To determine whether disposable surgical face masks worn by the surgical team during clean surgery prevent postoperative surgical wound infection.

Cochrane Systematic Review: Dressings for the prevention of surgical site infection

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Dumville JC, Walter CJ, Sharp CA, Page T

OBJECTIVES: To evaluate the effects of wound dressings for preventing SSI in people with surgical wounds healing by primary intention.

Cochrane Systematic Review: Use of plastic adhesive drapes during surgery for preventing surgical site infection

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Webster J, Alghamdi A

OBJECTIVES: To assess the effect of adhesive drapes used during surgery on surgical site infection, cost, mortality and morbidity.

Cochrane Systematic Review: Antibiotics for preventing infection in open limb fractures

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Gosselin, RA, Roberts, I, & Gillespie, WJ

Objective: To quantify the evidence for the effectiveness of antibiotics in the initial treatment of open fractures of the limbs.

Review: A critical review of recent clinical practice guidelines for pediatric urinary tract infection

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Chua M, Ming J, Chang SJ, Santos JD, Mistry N, Silangcruz JM, Bayley M, Koyle MA

Concerns regarding the quality, credibility, and applicability of recently published pediatric urinary tract infection (UTI) clinical practice guidelines have been raised due to the inconsistencies of recommendations between them. This review aimed to determine the quality of the recent clinical practice guidelines on pediatric UTI by using the Appraisal of Guidelines Research and Evaluation (AGREE II) instrument, and summarize the standard of care in diagnosis and management of pediatric UTI from the top three clinical practice guidelines.

Review: Urinary tract infection in children

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Hudson A, Romao RLP, MacLellan D

This review presents summary recommendations for diagnosing urinary tract infection in children.

Review: Pediatric urinary tract infection: does the evidence support aggressively pursuing the diagnosis?

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Newman DH, Shreves AE, Runde DP

The authors review both early and emerging literature to examine the utility and efficacy of early identification and treatment of urinary tract infection in children younger than 24 months.

Cochrane Systematic Review: Antibiotics for treating lower urinary tract infection in children

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Fitzgerald A, Mori R, Lakhanpaul M, Tullus K

This review aims to summarise the benefits and harms of antibiotics for treating lower urinary tract infection in children.

Systematic Review: Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months

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Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improv...

The objectives of this review are to revise the American Academy of Pediatrics practice parameter regarding the diagnosis and management of initial urinary tract infections in febrile infants and young children.

Cochrane Systematic Review: Long-term antibiotics for preventing recurrent urinary tract infection in children

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Williams G, Craig JC

The objectives of this review are to determine the efficacy and harms of long-term antibiotics to prevent recurrent urinary tract infections in children.

Systematic Review: Absolute and relative accuracy of rapid urine tests for urinary tract infection in children: a meta-analysis

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Williams GJ, Macaskill P, Chan SF, Turner RM, Hodson E, Craig JC

Rapid urine tests, such as microscopy, for bacteria and white cells, and dipsticks, for leucocyte esterase and nitrites, are often used in children that are unwell to guide early diagnosis and treatment of urinary tract infection. This review aimed to establish whether these tests were sufficiently sensitive to avoid urine culture in children with negative results and to compare the accuracy of dipsticks with microscopy.

Review: Does this child have a urinary tract infection?

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Shaikh N, Morone NE, Lopez J, Chianese J, Sangvai S, D'Amico F, Hoberman A, W...

This article reviews the diagnostic accuracy of symptoms and signs for the diagnosis of urinary tract infection in infants and children.

Systematic Review: Clinical effectiveness and cost-effectiveness of tests for the diagnosis and investigation of urinary tract infection in children: a systematic review and economic model

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Whiting P, Westwood M, Bojke L, Palmer S, Richardson G, Cooper J, Watt I, Gla...

The objectives of this systematic review are to determine the diagnostic accuracy of tests for detecting urinary tract infection (UTI) in children under 5 years of age and to evaluate the effectiveness of tests used to investigate further children with confirmed UTI. Also, to evaluate the effectiveness of following up children with UTI and the cost-effectiveness of diagnostic and imaging tests for the diagnosis and follow-up of UTI in children under 5. An additional objective was to develop a preliminary diagnostic algorithm for healthcare professionals.

Systematic Review: Rapid tests and urine sampling techniques for the diagnosis of urinary tract infection (UTI) in children under five years

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Whiting P, Westwood M, Watt I, Cooper J, Kleijnen J

This systematic review was conducted to determine the diagnostic accuracy of rapid tests for detecting urinary tract infection in children under five years of age.

Cochrane Systematic Review: Short versus standard duration oral antibiotic therapy for acute urinary tract infection in children

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Michael M, Hodson EM, Craig JC, Martin S, Moyer VA

The objective of this review was to assess the benefits and harms of short-course (2-4 days) compared to standard duration (7-14 days) oral antibiotic treatment for acute urinary tract infection in children.

Review: Neonatal Herpes Simplex Virus Infection

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James SH, Kimberlin DW

This review describes diagnostic and therapeutic advances for infants with herpes simplex virus 1 (HSV-1) and 2 (HSV-2).

Systematic Review: Systematic review of the diagnostic accuracy of C-reactive protein to detect bacterial infection in nonhospitalized infants and children with fever

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Sanders S, Barnett A, Correa-Velez I, Coulthard M, Doust J

The objective of this systematic review was to determine the accuracy of C-reactive protein (CRP) for diagnosing serious bacterial and bacterial infections in infants and children presenting with fever.

Systematic Review: Shiga Toxin-Producing Escherichia coli Infection, Antibiotics, and Risk of Developing Hemolytic Uremic Syndrome: A Meta-analysis

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Freedman SB, Xie J, Neufeld MS, Hamilton WL, Hartling L, Tarr PI; Alberta Pro...

This review assessed if antibiotic administration to individuals with Shiga toxin-producing Escherichia coli infection is associated with development of hemolytic uremic syndrome.

Systematic Review: Comparative study of Silver Sulfadiazine with other materials for healing and infection prevention in burns: A systematic review and meta-analysis

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Nmia HH, Carvalho VF, Isaac C, Souza F, Gemperli R, Paggiaro AO

Objective: The aim of this systematic review with meta-analysis was to compare the effect of Silver Sulfadiazine (SSD) with other new dressings, with or without silver, on healing and infection prevention in burns.

Cochrane Systematic Review: Antibiotic prophylaxis for preventing burn wound infection

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Barajas-Nava LA, Lpez-Alcalde J, Roqu i Figuls M, Sol I, Bonfill Cosp X

Objective: To assess the effects of antibiotic prophylaxis on rates of burn wound infection.

Cochrane Systematic Review: Clinical symptoms and signs for the diagnosis of Mycoplasma pneumoniae in children and adolescents with community-acquired pneumonia

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Wang K, Gill P, Perera R, Thomson A, Mant D, Harnden A.

Objectives: The objectives of this review are (i) to assess the diagnostic accuracy of symptoms and signs in the clinical recognition of M. pneumoniae in children and adolescents with community-acquired pneumonia; and (ii) to assess the influence of potential sources of heterogeneity on the diagnostic accuracy of symptoms and signs in the clinical recognition of M. pneumoniae.

Cochrane Systematic Review: Delayed antibiotics for respiratory infections

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Spurling GK, Del Mar CB, Dooley L, Foxlee R, Farley R.

Objectives: To evaluate the use of delayed antibiotics compared to immediate or no antibiotics as a prescribing strategy for ARTIs. We evaluated clinical outcomes including duration and severity measures for pain, malaise, fever, cough and rhinorrhoea in sore throat, otitis media, bronchitis (cough) and the common cold. We also evaluated the outcomes of antibiotic use, patient satisfaction, antibiotic resistance and re-consultation rates and use of alternative therapies.

Cochrane Systematic Review: Different antibiotic treatments for group A streptococcal pharyngitis

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van Driel ML, De Sutter AI, Keber N, Habraken H, Christiaens T.

Objectives: To assess the evidence on the comparative efficacy of different antibiotics in: (a) alleviating symptoms (pain, fever); (b) shortening the duration of the illness; (c) preventing relapse; and (d) preventing complications (suppurative complications, acute rheumatic fever, post-streptococcal glomerulonephritis). To assess the evidence on the comparative incidence of adverse effects and the risk-benefit of antibiotic treatment for streptococcal pharyngitis.

Cochrane Systematic Review: Heated, humidified air for the common cold

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Singh M, Singh M.

Objectives: To assess the effects of inhaling heated water vapour (steam) in the treatment of the common cold by comparing symptoms, viral shedding and nasal resistance.

Cochrane Systematic Review: Heliox inhalation therapy for bronchiolitis in infants

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Liet JM, Ducruet T, Gupta V, Cambonie G.

Objectives: To assess heliox in addition to standard medical care for acute bronchiolitis in infants.

Cochrane Systematic Review: Osmotic therapies added to antibiotics for bacterial meningitis

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Wall EC, Ajdukiewicz KM, Heyderman RS, Garner P.

Objectives: To evaluate the effects on mortality, deafness and neurological disability of osmotic therapies added to antibiotics for bacterial meningitis in children and adults.

Cochrane Systematic Review: Oxygen therapy for lower respiratory tract infections in children between 3 months and 15 years of age

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Rojas MX, Granados Rugeles C, Charry-Anzola LP.

Objectives: To determine in the treatment of LRTIs: the effectiveness of oxygen therapy and oxygen delivery methods; the safety of these methods; and indications for oxygen therapy.

Cochrane Systematic Review: Pelargonium sidoides extract for treating acute respiratory tract infections

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Timmer A, Gnther J, Motschall E, Rcker G, Antes G, Kern WV.

Objectives: To assess the efficacy and safety of P. sidoides for the treatment of ARIs in children and adults.

Cochrane Systematic Review: Pre-admission antibiotics for suspected cases of meningococcal disease

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Sudarsanam TD, Rupali P, Tharyan P, Abraham OC, Thomas K.

Objectives: To study the effectiveness and safety of pre-admission antibiotics versus no pre-admission antibiotics or placebo, and different pre-admission antibiotic regimens in decreasing mortality, clinical failure and morbidity in people suspected of meningococcal disease.

Cochrane Systematic Review: Probiotics for preventing acute upper respiratory tract infections

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Hao Q, Lu Z, Dong BR, Huang CQ, Wu T.

Objectives: To assess the effectiveness and safety of probiotics for preventing acute URTIs.

Cochrane Systematic Review: Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections

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Schuetz P, Mller B, Christ-Crain M, Stolz D, Tamm M, Bouadma L, Luyt CE, Wolf...

Objectives: The aim of this systematic review based on individual patient data was to assess the safety and efficacy of using procalcitonin for starting or stopping antibiotics over a large range of patients with varying severity of ARIs and from different clinical settings.

Cochrane Systematic Review: Rapid viral diagnosis for acute febrile respiratory illness in children in the Emergency Department

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Doan Q, Enarson P, Kissoon N, Klassen TP, Johnson DW.

Objectives: To determine the effect of rapid viral testing in the ED on the rate of precautionary testing, antibiotic use, and length of ED visit.

Cochrane Systematic Review: Ribavirin for respiratory syncytial virus infections of the lower respiratory tract in infants and young children

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Ventre K, Randolph A.

Objectives: The objective of this review is to assess the efficacy of aerosolized ribavirin for infants and children with lower respiratory tract infections due to RSV.

Cochrane Systematic Review: Saline nasal irrigation for acute upper respiratory tract infections

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Kassel JC, King D, Spurling GK.

Objectives: To evaluate the efficacy of saline nasal irrigation in treating the symptoms of acute URTIs.

Cochrane Systematic Review: Short-course versus long-course antibiotic therapy for non-severe community-acquired pneumonia in children aged 2 months to 59 months

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Kozyrskyj A, Klassen TP, Moffatt M, Harvey K.

Objectives: To determine the effectiveness of a short course of antibiotics (less than seven days) in comparison to a long course of antibiotics (seven days or greater) for the treatment of AOM in children.

Cochrane Systematic Review: Short-term late-generation antibiotics versus longer term penicillin for acute streptococcal pharyngitis in children

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Altamimi S, Khalil A, Khalaiwi KA, Milner RA, Pusic MV, Al Othman MA.

Objectives: To summarize the evidence regarding the efficacy of two to six days of newer oral antibiotics (short duration) compared to 10 days of oral penicillin (standard duration) in treating children with acute GABHS pharyngitis.

Cochrane Systematic Review: Vitamin C for preventing and treating pneumonia

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Hemil H, Louhiala P.

Objectives: To assess the prophylactic and therapeutic effects of vitamin C on pneumonia.

Cochrane Systematic Review: Antibiotics for persistent cough or wheeze following acute bronchiolitis in children

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McCallum GB, Morris PS, Chang AB.

Objectives: To determine the effectiveness of antibiotics compared to a control (no treatment or placebo) for persistent respiratory symptoms (within six months), following acute bronchiolitis.

Cochrane Systematic Review: Inhaled steroids for episodic viral wheeze of childhood

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McKean M, Ducharme F.

Objectives: The objective of this review was to identify whether corticosteroid treatment, given episodically or daily, is beneficial to children with viral episodic wheeze.

Cochrane Systematic Review: Antibiotic treatment for Burkholderia cepacia complex in people with cystic fibrosis experiencing a pulmonary exacerbation

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Horsley A, Jones AM

OBJECTIVES: To assess the effectiveness and safety of different antibiotic regimens in people with cystic fibrosis experiencing an exacerbation, who are chronically infected with organisms of the Burkholderia cepacia complex.

Cochrane Systematic Review: Antibiotics for treating community acquired pneumonia in people with sickle cell disease

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Mart-Carvajal AJ, Conterno LO

OBJECTIVES: To determine the efficacy and safety of the antibiotic treatment approaches (monotherapy or combined) for people with sickle cell disease suffering from community-acquired pneumonia.

Cochrane Systematic Review: Home versus hospital intravenous antibiotic therapy for cystic fibrosis

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Balaguer A, Gonzlez de Dios J

OBJECTIVES: To determine whether home intravenous antibiotic therapy in cystic fibrosis is as effective as inpatient intravenous antibiotic therapy and if it is preferred by individuals or families or both.

Cochrane Systematic Review: Inhaled antibiotics for pulmonary exacerbations in cystic fibrosis

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Ryan G, Jahnke N, Remmington T

OBJECTIVES: To determine if treatment of pulmonary exacerbations with inhaled antibiotics in people with cystic fibrosis improves their quality of life, reduces time off school or work and improves their long-term survival.

Cochrane Systematic Review: Interventions for the eradication of methicillin-resistant Staphylococcus aureus (MRSA) in people with cystic fibrosis

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Lo DK, Hurley MN, Muhlebach MS, Smyth AR

OBJECTIVES: To evaluate the effectiveness of treatment regimens designed to eradicate MRSA and to determine whether the eradication of MRSA confers better clinical and microbiological outcomes for people with cystic fibrosis.

Cochrane Systematic Review: Macrolide antibiotics for cystic fibrosis

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Southern KW, Barker PM, Solis-Moya A, Patel L

OBJECTIVES: To test the hypotheses that, in people with cystic fibrosis, macrolide antibiotics: 1. improve clinical status compared to placebo or another antibiotic; 2. do not have unacceptable adverse effects. If benefit was demonstrated, we aimed to assess the optimal type, dose and duration of macrolide therapy.

Cochrane Systematic Review: Once-daily versus multiple-daily dosing with intravenous aminoglycosides for cystic fibrosis

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Smyth AR, Bhatt J

OBJECTIVES: To assess the effectiveness and safety of once-daily versus multiple-daily dosing of intravenous aminoglycoside antibiotics for the management of pulmonary exacerbations in cystic fibrosis.

Cochrane Systematic Review: Oral anti-pseudomonal antibiotics for cystic fibrosis

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Remmington T, Jahnke N, Harkensee C

OBJECTIVES: To determine the benefit or harm of oral anti-pseudomonal antibiotic therapy for people with CF, colonised with Pseudomonas aeruginosa, in the:1. treatment of a pulmonary exacerbation; and 2. long-term treatment of chronic infection.

Cochrane Systematic Review: Antibiotics for otitis media with effusion in children

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van Zon A, van der Heijden GJ, van Dongen TM, Burton MJ, Schilder AG

OBJECTIVES: To assess the effects of antibiotics in children up to 18 years with OME.

Cochrane Systematic Review: Medical interventions for fungal keratitis

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FlorCruz NV, Peczon IV, Evans JR

OBJECTIVES: To examine the effect of different antifungal drugs in the management of fungal keratitis.

Cochrane Systematic Review: Vitamin A supplementation during pregnancy for maternal and newborn outcomes

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van den Broek N, Dou L, Othman M, Neilson JP, Gates S, Glmezoglu AM

OBJECTIVES: To review the effects of supplementation of vitamin A, or one of its derivatives, during pregnancy, alone or in combination with other vitamins and micronutrients, on maternal and newborn clinical outcomes.

Cochrane Systematic Review: Cranberries for treating urinary tract infections

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Jepson RG, Mihaljevic L, Craig J

OBJECTIVES: To assess the effectiveness of cranberries for the treatment of urinary tract infections.

Cochrane Systematic Review: Interventions for primary vesicoureteric reflux

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Nagler EV, Williams G, Hodson EM, Craig JC

OBJECTIVES: To evaluate the benefits and harms of different treatment options for primary VUR.

Cochrane Systematic Review: Modes of administration of antibiotics for symptomatic severe urinary tract infections

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Pohl A

OBJECTIVES: To assess whether the mode of administration of antibiotic therapy for severe UTI has an effect on cure rate, reinfection rate and kidney scarring.

Cochrane Systematic Review: Interventions to reduce Staphylococcus aureus in the management of atopic eczema

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Birnie AJ, Bath-Hextall FJ, Ravenscroft JC, Williams HC

OBJECTIVES: To assess the effects of interventions to reduce Staphylococcus aureus for treating infected or uninfected atopic eczema.

Cochrane Systematic Review: Antibiotic prophylaxis for mammalian bites

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Medeiros I, Saconato H

OBJECTIVES: To determine if the use of prophylactic antibiotics in mammalian bites is effective in preventing bite wound infection.

Cochrane Systematic Review: Honey as a topical treatment for wounds

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Jull AB, Walker N, Deshpande S

OBJECTIVES: The objective was to determine whether honey increases the rate of healing in acute wounds (e.g. burns, lacerations) and chronic wounds (e.g. skin ulcers, infected surgical wounds).

Cochrane Systematic Review: Primary closure versus delayed closure for non bite traumatic wounds within 24 hours post injury

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Eliya-Masamba MC, Banda GW

OBJECTIVES: To determine the effect on time to healing of primary closure versus delayed closure for non bite traumatic wounds presenting within 24 hours post injury. To explore the adverse effects of primary closure compared with delayed closure for non bite traumatic wounds presenting within 24 hours post injury.

Cochrane Systematic Review: Tissue adhesives for closure of surgical incisions

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Coulthard P, Esposito M, Worthington HV, van der Elst M, van Waes OJ, Darcey J

OBJECTIVES: To determine the relative effects of various tissue adhesives and conventional skin closure techniques on the healing of surgical wounds.

Cochrane Systematic Review: Water for wound cleansing

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Fernandez R, Griffiths R

OBJECTIVES: The objective of this review was to assess the effects of water compared with other solutions for wound cleansing.

Cochrane Systematic Review: Acetylcysteine and carbocysteine for acute upper and lower respiratory tract infections in paediatric patients without chronic broncho-pulmonary disease

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Chalumeau M, Duijvestijn YC

OBJECTIVES: The objective was to assess the efficacy and safety and to establish a benefit-risk ratio of acetylcysteine and carbocysteine as symptomatic treatments for acute upper and lower RTIs in paediatric patients without chronic broncho-pulmonary disease.

Cochrane Systematic Review: Antibiotics for community-acquired lower respiratory tract infections secondary to Mycoplasma pneumoniae in children

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Mulholland S, Gavranich JB, Gillies MB, Chang AB

OBJECTIVES: To determine whether antibiotics are effective in the treatment of childhood LRTI secondary to M. pneumoniae infections acquired in the community.

Cochrane Systematic Review: Antibiotics for community-acquired pneumonia in children

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Lodha R, Kabra SK, Pandey RM

OBJECTIVES: To identify effective antibiotic drug therapies for community-acquired pneumonia (CAP) of varying severity in children by comparing various antibiotics.

Cochrane Systematic Review: Fluid therapy for bacterial meningitis

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Bjerre LM, Verheij TJ, Kochen MM. Antibiotics for community acquired pneumon...

OBJECTIVES: To summarize current evidence from randomized controlled trials (RCTs) concerning the efficacy of different antibiotic treatments for CAP in participants older than 12.

Cochrane Systematic Review: Azithromycin for respiratory tract infections

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Panpanich R, Lerttrakarnnon P, Laopaiboon M

OBJECTIVES: To compare the effectiveness of azithromycin to amoxycillin or amoxycillin/clavulanic acid (amoxyclav) in the treatment of LRTI, in terms of clinical failure, incidence of adverse events and microbial eradication.

Cochrane Systematic Review: Chest radiograph for acute lower respiratory infections

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Swingler GH, Zwarenstein M

OBJECTIVES: To assess the effects of chest radiography on clinical outcome in acute lower respiratory infections.

Review: The clinical diagnosis and management of urinary tract infections in children and adolescents

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Korbel L, Howell M, Spencer JD

In this manuscript, the authors review the diagnosis and management of acute and recurrent urinary tract infection in the paediatric and adolescent populations.

Systematic Review: Global prevalence of antibiotic resistance in paediatric urinary tract infections caused by Escherichia coli and association with routine use of antibiotics in primary care: systematic review and meta-analysis

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Bryce A, Hay AD, Lane IF, Thornton HV, Wootton M, Costelloe C

Objectives: To systematically review studies investigating the prevalence of antibiotic resistance in urinary tract infections caused by Escherichia coli in children and, when appropriate, to meta-analyse the relation between previous antibiotics prescribed in primary care and resistance.

Review: Diagnosis of Urinary Tract Infections in Children

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Doern CD, Richardson SE

This review discusses the management and laboratory diagnoses of urinary tract infections in children. Important factors, such as specimen collection, urinalysis interpretation, culture thresholds, and antimicrobial susceptibility testing are covered.

Cochrane Systematic Review: Probiotics for preventing urinary tract infections in adults and children

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Schwenger EM, Tejani AM, Loewen PS

This systematic review addressed the questions: Compared to placebo or no therapy, did probiotics (any formulation) provide a therapeutic advantage in terms of morbidity and mortality, when used to prevent UTI in susceptible patient populations? Compared to other prophylactic interventions, including drug and non-drug measures (e.g. continuous antibiotic prophylaxis, topical oestrogen, cranberry juice), did probiotics (any formulation) provide a therapeutic advantage in terms of morbidity and mortality when used to prevent UTIs in susceptible patient populations?

Cochrane Systematic Review: Procalcitonin, C-reactive protein, and erythrocyte sedimentation rate for the diagnosis of acute pyelonephritis in children

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Shaikh N, Borrell JL, Evron J, Leeflang MM

The objectives of this review were to 1) determine whether procalcitonin, C-reactive protein, erythrocyte sedimentation rate can replace the acute DMSA scan in the diagnostic evaluation of children with urinary tract infections; 2) assess the influence of patient and study characteristics on the diagnostic accuracy of these tests, and 3) compare the performance of the three tests to each other.

Cochrane Systematic Review: Antibiotics for acute pyelonephritis in children

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Strohmeier Y, Hodson EM, Willis NS, Webster AC, Craig JC

The objectives of this review were to evaluate the benefits and harms of antibiotics used to treat children with acute pyelonephritis. The aspects of therapy considered were 1) different antibiotics, 2) different dosing regimens of the same antibiotic, 3) different duration of treatment, and 4) different routes of administration.

Systematic Review: Technical reportDiagnosis and management of an initial UTI in febrile infants and young children

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Finnell SM, Carroll AE, Downs SM; Subcommittee on Urinary Tract Infection

This report was developed to inform the revised, evidence-based, clinical guideline regarding the diagnosis and management of initial urinary tract infections in febrile infants and young children, 2 to 24 months of age, from the American Academy of Pediatrics Subcommittee on Urinary Tract Infection.

Key studies

Key Study: The Diagnosis of Urinary Tract infection in Young children (DUTY): a diagnostic prospective observational study to derive and validate a clinical algorithm for the diagnosis of urinary tract infection in children presenting to primary care

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Hay AD, Birnie K, Busby J, Delaney B, Downing H, Dudley J, Durbaba S, Fletche...

The objective of this study was to develop algorithms to accurately identify pre-school children in whom urine should be obtained; assess whether or not dipstick urinalysis provides additional diagnostic information; and model algorithm cost-effectiveness.

Key Study: Serum lactate as a screening tool and predictor of outcome in pediatric patients presenting to the emergency department with suspected infection (2013)

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Reed LC, J.; Cummings, A.; Markwell, S.; Wall, J.; Duong, M.

Objective: No single reliable sepsis biomarker exists for risk stratification and prognostication in pediatric patients presenting to the emergency department (ED). Serum lactate (LA) predicts mortality in septic adults. We sought to determine if serum LA correlated with the diagnosis of sepsis, admission rates, and outcomes in pediatric patients presenting to the ED with suspected infection. Published: 2013.

Key Study: Serum lactate as a predictor of mortality in patients with infection (2007)

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Trzeciak SD, R. P.; Chansky, M. E.; Arnold, R. C.; Schorr, C.; Milcarek, B.; ...

Objective: To determine the utility of an initial serum lactate measurement for identifying high risk of death in patients with infection. DESIGN AND SETTING: Post-hoc analysis of a prospectively compiled registry in an urban academic hospital. Published: 2007.

Key Study: Differentiation of systemic infection and congenital obstructive left heart disease in the very young infant

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Pickert CB, Moss MM, Fiser DH

This retrospective review of critically ill infants 0 to 28 days of age presenting with either bacterial sepsis or meningitis or a congenital obstructive left heart syndrome (COLHS), identifies historical, physical, or laboratory findings which might differentiate the two groups at presentation.

Key Study: Development and Validation of a Calculator for Estimating the Probability of Urinary Tract Infection in Young Febrile Children

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Shaikh N, Hoberman A, Hum SW, Alberty A, Muniz G, Kurs-Lasky M, Landsittel D,...

The objective of this study is to develop and test a calculator (UTICalc) that can first estimate the probability of urinary tract infection based on clinical variables and then update that probability based on laboratory results.

Key Study: Delayed treatment of the first febrile urinary tract infection in early childhood increased the risk of renal scarring

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Karavanaki KA, Soldatou A, Koufadaki AM, Tsentidis C, Haliotis FA, Stefanidis CJ

This study evaluated the controversial relationship between the duration of fever before treatment initiation for a febrile urinary tract infection, with renal scarring based on dimercaptosuccinic acid scintigraphy (DMSA) findings.

Key Study: Testing for Urinary Tract Infection in the Influenza/Respiratory Syncytial Virus-Positive Febrile Infant Aged 2 to 12 Months

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Schlechter Salinas AK, Hains DS, Jones T, Harrell C, Meredith M

This study assessed the prevalence of urinary tract infection (UTI) in febrile RSV/influenza positive infants aged 2 to 12 months presenting to the emergency department. We also examined whether the 2011 American Academy of Pediatrics UTI clinical practice guidelines could be used to identify patients at lower risk of UTI.

Key Study: Improving the Diagnosis and Treatment of Urinary Tract Infection in Young Children in Primary Care: Results from the DUTY Prospective Diagnostic Cohort Stud

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Hay AD, Sterne JA, Hood K, Little P, Delaney B, Hollingworth W, Wootton M, Ho...

Up to 50% of urinary tract infections (UTIs) in young children are missed in primary care. Urine culture is essential for diagnosis, but urine collection is often difficult. The aim of this study was to derive and internally validate a 2-step clinical rule using (1) symptoms and signs to select children for urine collection; and (2) symptoms, signs, and dipstick testing to guide antibiotic treatment.

Key Study: Predictors of Antimicrobial Resistance among Pathogens Causing Urinary Tract Infection in Children

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Shaikh N, Hoberman A, Keren R, Ivanova A, Gotman N, Chesney RW, Carpenter MA,...

The objective of this study was to determine which children with urinary tract infection are likely to have pathogens resistant to narrow-spectrum antimicrobials.

Key Study: Early Antibiotic Treatment for Pediatric Febrile Urinary Tract Infection and Renal Scarring

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Shaikh N, Mattoo TK, Keren R, Ivanova A, Cui G, Moxey-Mims M, Majd M, Ziessma...

The objective of this study was to determine whether delay in the initiation of antimicrobial therapy for febrile urinary tract infections is associated with the occurrence and severity of renal scarring.

Key Study: Accuracy of a new clean-catch technique for diagnosis of urinary tract infection in infants younger than 90 days of age

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Herreros ML, Tagarro A, Garca-Pose A, Snchez A, Caete A, Gili P

The objective of this study was to evaluate the accuracy of diagnosing urinary tract infections using a new, recently described, standardized clean-catch collection technique.

Key Study: Diagnostic accuracy of the urinalysis for urinary tract infection in infants <3 months of age

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Schroeder AR, Chang PW, Shen MW, Biondi EA, Greenhow TL

The purpose of this study was to determine the accuracy (sensitivity and specificity) of urinalysis for diagnosing urinary tract infection in infants <3 months of age.

Key Study: Does prompt treatment of urinary tract infection in preschool children prevent renal scarring: mixed retrospective and prospective audits

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Coulthard MG, Lambert HJ, Vernon SJ, Hunter EW, Keir MJ, Matthews JN

The objective of this study was to test whether active management of urinary tract infections in young children by general practitioners can reduce kidney scarring rates.

Key Study: Screening for urinary tract infection in infants in the emergency department: which test is best?

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Shaw KN, McGowan KL, Gorelick MH, Schwartz JS

The objective of this study wa to compare rapid tests and screening strategies for detecting urinary tract infection in infants.

Key Study: Is urine culture necessary to rule out urinary tract infection in young febrile children?

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Hoberman A, Wald ER, Reynolds EA, Penchansky L, Charron M

The objective of this study was to determine whether the absence of pyuria on the enhanced urinalysis can be used to eliminate the diagnosis of urinary tract infection, avoiding the need for urine culture and sparing large health care expenditures.

Key Study: Point-of-care C reactive protein to identify serious infection in acutely ill children presenting to hospital: prospective cohort study

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Verbakel JY, Lemiengre MB, De Burghgraeve T, De Sutter A, Aertgeerts B, Bulle...

This prospective study aimed to develop improved tools to assess children attending ambulatory hospital care, integrating clinical features with point-of-care C reactive protein (CRP).

Key Study: Prevalence of Concomitant Acute Bacterial Meningitis in Neonates with Febrile Urinary Tract Infection: A Retrospective Cross-Sectional Study

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Wallace SS, Brown DN, Cruz AT

The objective of this study was to describe the frequency of concomitant acute bacterial meningitis in neonates with febrile urinary tract infection.

Key Study: Initial Presentation of Neonatal Herpes Simplex Virus Infection

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Curfman AL, Glissmeyer EW, Ahmad FA, Korgenski EK, Blaschke AJ, Byington CL, ...

The objective of this study was to inform the decision to test and empirically treat for herpes simplex virus (HSV) by describing the initial clinical presentation and laboratory findings of infants with a confirmed diagnosis of neonatal HSV.

Key Study: Lack of Accuracy of Biomarkers and Physical Examination to Detect Bacterial Infection in Febrile Infants

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Daz MG, Garca RP, Gamero DB, Gonzlez-Tom MI, Romero PC, Ferrer MM, Contreras JR

The aim of this study was to analyze the usefulness of physical examination, C-reactive protein, procalcitonin, white blood cell count, and absolute neutrophils counts for the diagnosis of invasive bacterial infections and potentially serious bacterial infections in infants younger than the age of 3 months presenting with fever without source to the emergency department.

Key Study: Use of Procalcitonin Assays to Predict Serious Bacterial Infection in Young Febrile Infants

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Milcent K, Faesch S, Gras-Le Guen C, Dubos F, Poulalhon C, Badier I, Marc E, ...

The objective of this study was to assess the diagnostic characteristics of the procalcitonin assay for detecting serious bacterial infection and invasive bacterial infection in febrile infants aged 7 to 91 days.

Key Study: Value of white cell count in predicting serious bacterial infection in febrile children under 5 years of age

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De S, Williams GJ, Hayen A, Macaskill P, McCaskill M, Isaacs D, Craig JC

The objective of this study was to evaluate the accuracy of leukocyte count for the detection of serious bacterial infections in febrile children.

Key Study: Clinical and laboratory features of neonatal herpes simplex virus infection: a case-control study

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Caviness AC, Demmler GJ, Selwyn BJ

The objective of this study was to determine the unique clinical and laboratory features of neonates with and without herpes simplex virus infection admitted to Texas Children's Hospital during a 14-year period.

Key study: Asymptomatic cases in a family cluster with SARS-CoV-2 infection

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Wu X, Li T, Ou X, et al

Objective: To report the findings from different types of clinical specimens collected from 82 infected individuals

Key study: SARS-CoV-2 Infection in Children.

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Lu X, Zhang L, Du H, et al

Objective: In order to determine the spectrum of disease in children, we evaluated children infected with SARS-CoV-2 and treated at the Wuhan Childrens Hospital, the only center assigned by the central government for treating infected children under 16 years of age in Wuhan.

Key study: A Case Series of children with 2019 novel coronavirus infection: clinical and epidemiological features

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Jiehao C, Jing X, Daojiong L, et al

Objective: To report the clinical and epidemiological features in children with coronavirus diseases (COVID) in China.

Key study: Novel Coronavirus Infection in Hospitalized Infants Under 1 Year of Age in China

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Wei M, Yuan J, Liu Y, et al.,

Objective: For this retrospective study, authors identified all hospitalized infants diagnosed with COVID-19 infection between December 8, 2019, and February 6, 2020, in China and described demographic, epidemiologic, and clinical features.

Key Study: Risk of serious bacterial infection in young febrile infants with respiratory syncytial virus infections

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Levine DA, Platt SL, Dayan PS, Macias CG, Zorc JJ, Krief W, Schor J, Bank D, ...

Objective: to determine the risk of SBI in young febrile infants who are infected with RSV compared with those without RSV infections.

Key study: Anosmia and ageusia: not an uncommon presentation of COVID-19 infection in children and adolescents.

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Mak PQ, Chung KS, Wong JS, Shek CC, Kwan MY.

Objective: We report three cases of pediatric patients with COVID-19 infection who presented with anosmia and/or ageusia.

Key study: Characteristics and outcomes of children with Coronavirus disease 2019 (COVID-19) infection admitted to US and Canadian pediatric intensive care units.

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Shekerdemian L, Mahmood N, Wolfe K, et al.

Objective To provide an early description and characterization of COVID-19 infection in North American PICUs, focusing on mode of presentation, presence of comorbidities, severity of disease, therapeutic interventions, clinical trajectory, and early outcomes.

Key study: Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding

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Xu Y, Li X, Zhu B, et al.

Objective: We report epidemiological and clinical investigations on ten pediatric SARS-CoV-2 infection cases confirmed by real-time reverse transcription PCR assay of SARS-CoV-2 RNA.

Key Study: Accuracy of the Urinalysis for Urinary Tract Infections in Febrile Infants 60 Days and Younger

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Tzimenatos L, Mahajan P, Dayan PS, Vitale M, Linakis JG, Blumberg S, Borgiall...

This study evaluated the test characteristics of the urinalysis for diagnosing urinary tract infections, with and without associated bacteremia, in young febrile infants.

Key Study: Pathogens causing urinary tract infections in infants: a European overview by the ESCAPE study group

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Alberici I, Bayazit AK, Drozdz D, Emre S, Fischbach M, Harambat J, Jankauskie...

The objective of this study was to determine the pathogens in positive urine cultures from hospitalized and non-hospitalized infants under 24 months of age.

Key Study: Outpatient management of young febrile infants with urinary tract infections

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Schnadower D, Kuppermann N, Macias CG, Freedman SB, Agrawal D, Mao J, Dayan P...

This study aimed to determine the variation in patient disposition for young febrile infants who present to emergency departments with urinary tract infections and clinical factors independently associated with outpatient management.

Key Study: Reliability of the urinalysis for predicting urinary tract infections in young febrile children

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Bachur R, Harper MB

The objectives of this study were to determine how the sensitivity of the standard urinalysis as a screening test for urinary tract infection varies with age, and to determine the clinical situation that necessitates the collection of a urine culture regardless of the urinalysis result.

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Emergency Medicine Cases Podcast: Pediatric UTI Myths and Misperceptions

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Episode 123: On the one hand, UTI is one of the most common bacterial infections in children younger than 2 years of age and could lead to sepsis acutely and theoretically renal failure in the long run. On the other hand, it is important not to over-diagnose UTIs because we know that overuse of antibiotics increases costs, side effects and leads to antibiotic resistance. The first principles questions very much apply here: who to screen, how to screen, and what to do with the screen results. There are risks associated with not having a standardized approach to diagnosing pediatric UTIs. In this EM Cases main episode podcast with Dr. Olivia Ostrow and Dr. Michelle Science we discuss an approach to diagnosing pediatric UTIs whilst revealing some common pediatric UTI myths and misperceptions. Published online: April 2019

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