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Child UTI score ‘better than clinical diagnosis’

A new symptoms-based clinical rule is better at predicting children who have a UTI than GPs’ clinical judgement, say UK researchers.

The Diagnosis of Urinary Tract infections in Young children (DUTY) study is the largest study looking at the diagnosis of UTIs in children in primary care, with 7,000 children included.

They found that a symptom score including signs and symptoms such as pain when passing, smelly urine and absence of cough could predict whether urine sampling was necessary and was a better predictor of actual infection when compared with clinical diagnosis by GPs. Fever was not found to be predictive of a UTI.

The researchers concluded: ’Our rule can be used to enhance current clinical practice in the identification of young children for non-invasive urine sampling in primary care.

‘Fever should not be used to stratify UTI probability, and dipstick testing can be used to improve specificity for empiric antibiotic treatment in this population.’

Ann Fam Med 2016;14:325-336