{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T21:14:57Z","timestamp":1792271697499,"version":"4.4.0"},"reference-count":14,"publisher":"The Pediatric Pharmacy Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:sec>\n          <jats:title>OBJECTIVE<\/jats:title>\n          <jats:p>To characterize the diagnosis and management of urinary tract infection (UTI) in pediatric patients at the University of Illinois Hospital and Health Sciences System (UIH), with an emphasis on antibiotic prescribing; in addition, to characterize pediatric uropathogen patterns to help guide future empiric therapy choices.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>METHODS<\/jats:title>\n          <jats:p>We used a retrospective, descriptive study of pediatric patients ages 2 months to \u226418 years seen at the UIH emergency department or clinic from January 1, 2014, to August 31, 2018, with ICD-9 or ICD-10 discharge diagnosis of UTI. Data collected included presenting symptoms, urinalysis, details of antibiotic regimens, urine culture, and susceptibility results.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>RESULTS<\/jats:title>\n          <jats:p>Of the 207 patients included, the median age was 5.7 years (IQR, 3.2\u20139.4), and 183 patients (88.4%) were female. Common symptoms included dysuria (57%) and fever (37%). Empiric antibiotics were p-rescribed in 96.1% of cases, most commonly cefdinir (42%), cephalexin (22%), and sulfamethoxazole-trimethoprim (14%). Urine cultures were collected in 161 patients (77.8%), with 81 growing &gt;50,000 colony-forming units bacteria. <jats:italic>Escherichia coli<\/jats:italic> was the most commonly isolated organism (82.1%), showing susceptibility to third-generation cephalosporins (97%), nitrofurantoin (95%), and sulfamethoxazole-trimethoprim (84%). Although 25 urine cultures showed no growth, antibiotics were discontinued in only 4 cases.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>CONCLUSIONS<\/jats:title>\n          <jats:p>Pediatric patients with UTI symptoms were often empirically prescribed cefdinir, possibly an unnecessarily broad choice because many <jats:italic>E coli<\/jats:italic> isolates were susceptible to narrower agents. Both urinalysis and urine cultures should be obtained during the diagnostic evaluation of UTI, with better follow-up of negative cultures to potentially discontinue antibiotics. This study highlights areas for improvement in the diagnosis, treatment, and antimicrobial stewardship in pediatric UTI.<\/jats:p>\n        <\/jats:sec>","DOI":"10.5863\/1551-6776-28.3.241","type":"journal-article","created":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T01:59:24Z","timestamp":1686189564000},"page":"241-246","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of Outpatient Antibiotic Prescribing for Urinary Tract Infection in Pediatric Patients Ages 2 Months to 18 Years"],"prefix":"10.5863","volume":"28","author":[{"given":"Michelle M.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Pharmacy (MML), Ann & Robert H. Lurie Children's Hospital, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie","family":"Briars","sequence":"additional","affiliation":[{"name":"Department of Pharmacy (LB, KHO, AG, LMO), University of Illinois at Chicago College of Pharmacy, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten H.","family":"Ohler","sequence":"additional","affiliation":[{"name":"Department of Pharmacy (LB, KHO, AG, LMO), University of Illinois at Chicago College of Pharmacy, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Pharmacy (LB, KHO, AG, LMO), University of Illinois at Chicago College of Pharmacy, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren M.","family":"Oliveri","sequence":"additional","affiliation":[{"name":"Department of Pharmacy (LB, KHO, AG, LMO), University of Illinois at Chicago College of Pharmacy, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3883","reference":[{"issue":"11","key":"i2331-348X-28-3-241-b1","series-title":"Pharmacotherapy","first-page":"1026","article-title":"Making a case for pediatric antimicrobial stewardship programs","volume":"35","year":"2015","unstructured":"Magsarili\n              HK,\n            \n            \n              Girotto\n              JE,\n            \n            \n              Bennett\n              NJ.\n            \n          \n          Making a case for pediatric antimicrobial stewardship programs.\n\t\t\t\t\tPharmacotherapy.\n\t\t\t\t\t2015;\n\t\t\t\t\t35(\n\t\t\t\t\t11):\n\t\t\t\t\t1026\u2013\n\t\t\t\t\t1036."},{"key":"i2331-348X-28-3-241-b2","article-title":"Core elements of hospital antimicrobial stewardship programs. Centers for Disease Control and Prevention Web site","unstructured":"Core elements of hospital antimicrobial stewardship programs. Centers for Disease Control and Prevention Web site.\n\t\t\t\t\tPublished May 7, 2015. Updated February 23, 2017. Accessed August 19, 2018. https:\/\/www.cdc.gov\/antibiotic-use\/healthcare\/implementation\/core-elements.html"},{"issue":"4","key":"i2331-348X-28-3-241-b3","series-title":"Paediatr Int Child Health","first-page":"273","article-title":"The clinical diagnosis and management of urinary tract infection in children and adolescents","volume":"37","year":"2017","unstructured":"Korbel\n              L,\n            \n            \n              Howell\n              M,\n            \n            \n              Spencer\n              JD.\n            \n          \n          The clinical diagnosis and management of urinary tract infection in children and adolescents.\n\t\t\t\t\tPaediatr Int Child Health.\n\t\t\t\t\t2017;\n\t\t\t\t\t37(\n\t\t\t\t\t4):\n\t\t\t\t\t273\u2013\n\t\t\t\t\t279."},{"issue":"3","key":"i2331-348X-28-3-241-b4","series-title":"Pediatrics","first-page":"595","article-title":"Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months","volume":"128","year":"2011","unstructured":"Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management.\n          \n          Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months.\n\t\t\t\t\tPediatrics.\n\t\t\t\t\t2011;\n\t\t\t\t\t128(\n\t\t\t\t\t3):\n\t\t\t\t\t595\u2013\n\t\t\t\t\t610."},{"issue":"2","key":"i2331-348X-28-3-241-b5","series-title":"Clin Microbiol Rev","first-page":"417","article-title":"Diagnosis and management of pediatric urinary tract infections","volume":"18","year":"2005","unstructured":"Zorc\n              JJ,\n            \n            \n              Kiddoo\n              DA,\n            \n            \n              Shaw\n              KN.\n            \n          \n          Diagnosis and management of pediatric urinary tract infections.\n\t\t\t\t\tClin Microbiol Rev.\n\t\t\t\t\t2005;\n\t\t\t\t\t18(\n\t\t\t\t\t2):\n\t\t\t\t\t417\u2013\n\t\t\t\t\t422."},{"key":"i2331-348X-28-3-241-b6","article-title":"Urinary tract infection in under 16s: diagnosis and management. National Institute for Health and Care Excellence Web site","unstructured":"Urinary tract infection in under 16s: diagnosis and management. National Institute for Health and Care Excellence Web site.\n\t\t\t\t\tPublished August 22, 2007. Updated September 2017. Accessed August 19, 2018. https:\/\/www.nice.org.uk\/guidance\/cg54"},{"issue":"8","key":"i2331-348X-28-3-241-b7","series-title":"Ann Pharmacother","first-page":"757","article-title":"Association of antibiotic treatment duration with recurrence of uncomplicated urinary tract infection in pediatric patients","volume":"54","year":"2020","unstructured":"Afolabi\n              TM,\n            \n            \n              Goodlet\n              KJ,\n            \n            \n              Fairman\n              KA.\n            \n          \n          Association of antibiotic treatment duration with recurrence of uncomplicated urinary tract infection in pediatric patients.\n\t\t\t\t\tAnn Pharmacother.\n\t\t\t\t\t2020;\n\t\t\t\t\t54(\n\t\t\t\t\t8);\n\t\t\t\t\t757\u2013\n\t\t\t\t\t766."},{"issue":"5","key":"i2331-348X-28-3-241-b8","series-title":"Pediatrics","first-page":"e70","article-title":"A meta-analysis of randomized, controlled trials comparing short- and long-course antibiotic therapy for urinary tract infections in children","volume":"109","year":"2002","unstructured":"Keren\n              R,\n            \n            \n              Chan\n              E.\n            \n          \n          A meta-analysis of randomized, controlled trials comparing short- and long-course antibiotic therapy for urinary tract infections in children.\n\t\t\t\t\tPediatrics.\n\t\t\t\t\t2002;\n\t\t\t\t\t109(\n\t\t\t\t\t5):\n\t\t\t\t\te70."},{"issue":"6","key":"i2331-348X-28-3-241-b9","series-title":"J Pediatr Urol","first-page":"567","article-title":"Urinary tract infection in children: diagnosis, treatment, imaging--comparison of current guidelines","volume":"13","year":"2017","unstructured":"Okarska-Napierala\n              M,\n            \n            \n              Wasilewska\n              A,\n            \n            \n              Kuchar\n              E.\n            \n          \n          Urinary tract infection in children: diagnosis, treatment, imaging--comparison of current guidelines.\n\t\t\t\t\tJ Pediatr Urol.\n\t\t\t\t\t2017:\n\t\t\t\t\t13(\n\t\t\t\t\t6):\n\t\t\t\t\t567\u2013\n\t\t\t\t\t573."},{"issue":"6","key":"i2331-348X-28-3-241-b10","series-title":"Pediatrics","first-page":"1027","article-title":"National ambulatory antibiotic prescribing patterns for pediatric urinary tract infection, 1998\u20132007","volume":"127","year":"2011","unstructured":"Copp\n              HL,\n            \n            \n              Shapiro\n              DJ,\n            \n            \n              Hersh\n              AL.\n            \n          \n          National ambulatory antibiotic prescribing patterns for pediatric urinary tract infection, 1998\u20132007.\n\t\t\t\t\tPediatrics.\n\t\t\t\t\t2011;\n\t\t\t\t\t127(\n\t\t\t\t\t6):\n\t\t\t\t\t1027\u2013\n\t\t\t\t\t1033."},{"issue":"2","key":"i2331-348X-28-3-241-b11","series-title":"Pediatr Emer Care","first-page":"93","article-title":"Urinary tract infection and antimicrobial steward-ship in the emergency department","volume":"34","year":"2018","unstructured":"Watson\n              JR,\n            \n            \n              Sanchez\n              PJ,\n            \n            \n              Spencer\n              JD,\n            \n            \n              Cohen\n              DM,\n            \n            \n              Hains\n              DS.\n            \n          \n          Urinary tract infection and antimicrobial steward-ship in the emergency department.\n\t\t\t\t\tPediatr Emer Care.\n\t\t\t\t\t2018;\n\t\t\t\t\t34(\n\t\t\t\t\t2):\n\t\t\t\t\t93\u2013\n\t\t\t\t\t95."},{"key":"i2331-348X-28-3-241-b12","series-title":"Performance Standards for Antimicrobial Susceptibility Testing","year":"2018","unstructured":"Performance Standards for Antimicrobial Susceptibility Testing\n          .\n\t\t\t\t\tCLSI supplement M100.Wayne, PA:\n\t\t\t\t\tClinical and Laboratory Standards Institute;\n\t\t\t\t\t2018."},{"key":"i2331-348X-28-3-241-b13","series-title":"Front Pediatr","first-page":"675759","article-title":"Underutilization of narrow-spectrum antibiotics in the ambulatory management of pediatric UTI: a single-center experience","volume":"9","year":"2021","unstructured":"Lee\n              P,\n            \n            \n              Kim\n              M,\n            \n            \n              Herold\n              BC,\n            \n            \n              Soma\n              VL.\n            \n          \n          Underutilization of narrow-spectrum antibiotics in the ambulatory management of pediatric UTI: a single-center experience.\n\t\t\t\t\tFront Pediatr.\n\t\t\t\t\t2021;\n\t\t\t\t\t9:\n\t\t\t\t\t675759."},{"key":"i2331-348X-28-3-241-b14","series-title":"Pediatr Emer Care","first-page":"150","article-title":"Antibiotic prescription practice for pediatric urinary tract infection in a tertiary center","volume":"37","year":"2021","unstructured":"Alghounaim\n              M,\n            \n            \n              Ostrow\n              O,\n            \n            \n              Timberlake\n              K,\n            \n            \n              Richardson\n              SE,\n            \n            \n              Koyle\n              M,\n            \n            \n              Science\n              M.\n            \n          \n          Antibiotic prescription practice for pediatric urinary tract infection in a tertiary center.\n\t\t\t\t\tPediatr Emer Care.\n\t\t\t\t\t2021;\n\t\t\t\t\t37:\n\t\t\t\t\t150\u2013\n\t\t\t\t\t154."}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/28\/3\/article-p241.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/jppt\/article-pdf\/28\/3\/241\/3229092\/i2331-348x-28-3-241.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/28\/3\/article-p241.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/28\/3\/article-p241.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:49:03Z","timestamp":1747356543000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/28\/3\/article-p241.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023]]},"references-count":14,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.5863\/1551-6776-28.3.241","relation":{},"ISSN":["2331-348X","1551-6776"],"issn-type":[{"value":"2331-348X","type":"electronic"},{"value":"1551-6776","type":"print"}],"subject":[],"published":{"date-parts":[[2023]]}}}