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Published on: August 30, 2018
Antibiotic Stewardship in Pediatric Urinary Tract Infections: Current Evidence and Practical Strategies
Manar O Lashkar1, Milap C Nahata2,3
1Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah 22254, Saudi Arabia.
Antibiotics (Basel, Switzerland)
|July 27, 2026
Summary
Optimizing antibiotic use in children with urinary tract infections (UTIs) involves diagnostic stewardship and shorter treatment durations. Evidence supports oral therapy and selective prophylaxis, reducing unnecessary antibiotic exposure and resistance.
Area of Science:
- Pediatric Infectious Diseases
- Antimicrobial Stewardship
- Urology
Background:
- Pediatric urinary tract infections (UTIs) are common, leading to significant antibiotic prescribing.
- Current prescribing practices often deviate from evidence-based guidelines, contributing to antimicrobial resistance.
- A specialized stewardship approach is needed for pediatric UTIs.
Purpose of the Study:
- To evaluate international guidelines for pediatric UTI treatment and antibiotic stewardship integration.
- To identify evidence-based interventions for optimizing antibiotic prescribing in pediatric UTIs.
- To assess the impact of stewardship programs on prescribing appropriateness.
Main Methods:
- Literature search of PubMed and MEDLINE (2000-2026) for pediatric UTI and antibiotic stewardship studies.
- Evaluation of 13 international guidelines (2011-2025) focusing on stewardship principles.
- Inclusion of clinical trials, systematic reviews, and meta-analyses; exclusion of case reports.
Main Results:
- Significant variations exist in UTI diagnostic criteria and treatment recommendations across guidelines.
- Diagnostic stewardship, oral therapy, and early IV-to-oral transition are effective strategies.
- Shorter treatment durations (3-5 days) and selective prophylaxis are appropriate for specific pediatric UTI cases.
Conclusions:
- Antibiotic stewardship for pediatric UTIs encompasses diagnostics, treatment duration, and prophylaxis.
- Evidence-based interventions can reduce unnecessary antibiotic exposure without compromising outcomes.
- Further research on stewardship guidelines, resistance surveillance, and patient-centered outcomes is crucial.
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