TY - JOUR
T1 - Negative urinalyses in febrile infants age 7 to 60 days treated for urinary tract infection
AU - Schroeder, Alan R.
AU - Lucas, Brian P.
AU - Garber, Matthew D.
AU - McCulloh, Russell J.
AU - Joshi-Patel, Ashley A.
AU - Biondi, Eric A.
N1 - Funding Information:
The authors would like to thank all of the site directors who participated in the REVISE project, and Brittany Jennings, Naji Hattar, Faiza Wasif, and Vanessa Shorte at the American Academy of Pediatrics for their leadership and management.
Publisher Copyright:
© 2019 Society of Hospital Medicine.
PY - 2019/2
Y1 - 2019/2
N2 - 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.
AB - 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.
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U2 - 10.12788/jhm.3120
DO - 10.12788/jhm.3120
M3 - Article
C2 - 30785417
AN - SCOPUS:85061848034
SN - 1553-5592
VL - 14
SP - 101
EP - 104
JO - Journal of Hospital Medicine
JF - Journal of Hospital Medicine
IS - 2
ER -