This handout is for pediatric uti (neonate / infant / older child / adolescent; vur, recurrent, dysfunctional voiding). Your care team identified this based on: infant <2 mo with rectal temperature ≥38.0°c — uti is on the differential; full workup pathway (peds.febrile-infant.core.v1) (aap 2011).
Other reasons your team may use this plan: febrile child 2–24 mo without clear source — ua + culture per aap 2011 bagga criteria (pmid 21873693); verbal child / adolescent with dysuria + frequency + urgency (similar to adult uncomplicated cystitis); first uti in a male child — always abnormal until proven otherwise (posterior urethral valves / vur workup) (aap 2011).
Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.
| Medication | Starting dose | How | When | What it does |
|---|---|---|---|---|
| ampicillin | 50–100 mg/kg/dose IV q6–8h (neonatal dosing) | IV | q6–8h | Pediatric neonatal sepsis empiric — Listeria + Enterococcus coverage (peds.febrile-infant.core.v1) |
| gentamicin | 4–5 mg/kg/dose IV q24h (neonatal — adjust per gestational age) | IV | q24h | Pediatric neonatal sepsis empiric — gram-negative coverage; renal function monitoring (peds.febrile-infant.core.v1) |
| cefotaxime | 50 mg/kg/dose IV q8h (neonatal) | IV | q8h | Alternative to gent — better CNS penetration if meningitis concern (AAP) |
Plan: Pediatric UTI — age-tiered empiric (IV in <2 mo, IV ceftriaxone or oral cef in 2–24 mo, oral amoxicillin / cephalexin / TMP-SMX in older child) + VUR prophylaxis (TMP-SMX or nitrofurantoin low-dose) + AVOID FQ / tetracyclines <8 yo / sulfa <2 mo
Contact your care team if any of the following happen:
Call 911 or go to the nearest emergency room right away if you have:
Renal + bladder US in 2–24 mo after first febrile UTI; VCUG if atypical / recurrent / abnormal US; DMSA if recurrent; urology referral if VUR / anatomic anomaly / male / recurrent; prophylaxis discussion (RIVUR / PRIVENT); dysfunctional voiding pathway (uro.urinary-incontinence-eval.v1); circumcision discussion in recurrent uncircumcised (AAP 2011)
Guideline: AAP 2011 UTI Clinical Practice Guideline (Roberts) + AAP 2016 reaffirmation + RIVUR antimicrobial-prophylaxis VUR trial 2014 + IDSA Asymptomatic Bacteriuria 2019 (do-not-treat ASB)