title: Management of urinary tract infections in children in an era of increasing antimicrobial resistance.
abstract: Accurate diagnosis and appropriate use of antimicrobials for treatment and prevention of urinary tract infections (UTIs) is vital in an era of increasing antibiotic resistance.
  
  
  
  The article reviews indications for and interpretation of urinalysis and urine culture results for diagnosis of UTI, choice of antibiotics for empiric and definitive UTI therapy, the rationale behind and indications for radiographic investigations, and prevention of UTIs including the complex decision as to whether antibiotic prophylaxis will benefit a child. Expert commentary: Over-diagnosis of UTI is a prevalent problem due to the lack of specificity of both urinalysis and urine culture. The most major recent advance in the field has been the recognition that antibiotic prophylaxis for UTI is rarely indicated as in most situations, the number needed to treat to prevent one UTI is too high to justify the risk of adverse events and development of antimicrobial resistance.
authors.affiliation: a Department of Pediatrics , Stollery Children's Hospital and University of Alberta , Edmonton , Canada.
authors.forename: Joan L
authors.initials: JL
authors.lastname: Robinson
authors.affiliation: b Department of Pediatrics , Children's Hospital of Eastern Ontario and University of Ottawa , Ottawa , Canada.
authors.forename: Nicole
authors.initials: N
authors.lastname: Le Saux
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000009:adverse effects; D002648:Child; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D006801:Humans; D016482:Urinalysis; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology* / Q000517:prevention & control / Q000652:urine; D014556:Urine / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Urinary tract infection; antimicrobial resistance; pediatric