title: NICE Guidelines Cannot Be Recommended for Imaging Studies in Children Younger Than 3 Years with Urinary Tract Infection.
abstract: BACKGROUND
  We assessed the possible consequences of applying the National Institute of Health and Clinical Excellence (NICE) guidelines for imaging studies of children younger than 3 years with urinary tract infection (UTI) to clinical practice, in terms of altered diagnoses and treatment.
  
  
  METHODS
  In a retrospective cohort of 672 patients with UTI, we evaluated indications for and results of renal and bladder ultrasonography, voiding cystourethrography (VCUG), dimercaptosuccinic acid scintigraphy, UTI recurrence, antimicrobial prophylaxis (AMP), antireflux procedures, and other urological procedures.
  
  
  RESULTS
  There were a total 125 patients with vesicoureteral reflux (VUR), of whom 59 patients (47%) would have been missed, had the NICE guidelines being applied. These included 20 of the 64 patients (31%) with dilating VUR and 13 of the 30 patients (43%) who underwent antireflux procedures. A VCUG would have been avoided in 184 patients (74%) with no VUR in VCUG.
  
  
  CONCLUSIONS
  Based on the results in this cohort of 672 patients, we cannot recommend the use of the NICE guidelines for imaging studies in children younger than 3 years with UTI.
authors: Department of Pediatric Surgery, Turku University Hospital, Turku, Varsinais-Suomi, Finland.
authors: Marko Tapani
authors: MT
authors: Ristola
authors: Department of Pediatric Surgery, Turku University Hospital, Turku, Varsinais-Suomi, Finland.
authors: Timo
authors: T
authors: Hurme
mesh_terms: D019072:Antibiotic Prophylaxis; D002675:Child, Preschool; D003952:Diagnostic Imaging; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging; D008297:Male; D017410:Practice Guidelines as Topic; D011859:Radiography; D012189:Retrospective Studies; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000209:etiology*; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000175:diagnosis