Negative urinalyses in febrile infants age 7 to 60 days treated for urinary tract infection

Alan R. Schroeder, Brian P. Lucas, Matthew D. Garber, Russell J. McCulloh, Ashley A. Joshi-Patel, Eric A. Biondi

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

The role of the urinalysis (UA) in the management of young, febrile infants is controversial. To assess how frequently infants are treated for urinary tract infection (UTI) despite having normal UA values and to compare the characteristics of infants treated for UTI who have positive versus negative UAs, we reviewed 20,570 well-appearing febrile infants 7-60 days of age evaluated at 124 hospitals in the United States who were included in a national quality improvement project. Of 19,922 infants without bacteremia and meningitis, 2,407 (12.1%) were treated for UTI, of whom 2,298 (95.5%) had an initial UA performed. UAs were negative in 337/2,298 (14.7%) treated subjects. The proportion of infants treated for UTI with negative UAs ranged from 0%-35% across hospitals. UA-negative subjects were more likely to have respiratory symptoms and less likely to have abnormal inflammatory markers than UA+ subjects, indicating that they are mounting less of an inflammatory response to their underlying illness and/or might have contaminated specimens or asymptomatic bacteriuria.

Original languageEnglish (US)
Pages (from-to)101-104
Number of pages4
JournalJournal of hospital medicine
Volume14
Issue number2
DOIs
StatePublished - Feb 2019

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ASJC Scopus subject areas

  • Leadership and Management
  • Internal Medicine
  • Fundamentals and skills
  • Health Policy
  • Care Planning
  • Assessment and Diagnosis

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