The New American Academy of Pediatrics Urinary Tract Infection Guideline

This issue of Pediatrics includes a long-awaited update¹  of the American Academy of Pediatrics (AAP) 1999 urinary tract infection (UTI) practice parameter.²  The new guideline is accompanied by a technical report³  that provides a comprehensive literature review and also a new meta-analysis, for which the authors obtained individual-level data from investigators. The result is an exceptionally evidence-based guideline that differs in important ways from the 1999 guideline and sets a high standard for transparency and scholarship.

The guideline and technical report address a logical sequence of questions that arise clinically, including (1) Which children should have their urine tested? (2) How should the sample be obtained? (3) How should UTIs be treated? (4) What imaging and follow-up are recommended after a diagnosis of UTI? and (5) How should children be followed after a UTI has been diagnosed? I will follow that same sequence in this commentary. I...