Background: Urinary Tract Infection (UTI) is a common cause of bacterial infection in
young children, and accounts for a significant number of pediatric hospitalizations.
Objective: To review recent publications focusing on the care of children hospitalized with their first
Methods: A PubMed search was performed including publications from 2011-2016 on first febrile
UTI in childhood. Abstracts were reviewed for being relevant to the care of hospitalized children and
their follow-up. Relevant articles underwent full review by all authors and articles excluded from results
included those without novel data analysis, primary improvement-based reports and studies with
poor design or analysis. Included articles were categorized as “diagnosis”, “management”, “imaging”
Results: Of 406 articles initially identified, 40 studies were included. One technical report with a systematic
review was also included. Major topics addressed included the role of urinalysis in screening
for UTI, use of parenteral antimicrobial therapy, the role of antimicrobial prophylaxis in prevention of
recurrent UTI, and ideal follow-up and imaging approach following diagnosis of febrile UTI.
Conclusion: Recent literature on first febrile UTI addresses a broad range of areas regarding the care
of hospitalized children, though some questions remain unanswered. Overall, studies support increased
attention to the potential risks, expense and invasiveness of various approaches for evaluation.
Proposed updates to practice included: utilization of urinalysis for screening and diagnosis, transitioning
to oral antimicrobials based on clinical improvement and limiting the routine use of voiding
cystourethrogram and antimicrobial prophylaxis.