Urinary tract infection in child — MCCQE Part 1 MCQ

Correct answer: D — Send urine culture and start appropriate antibiotics

Send urine culture and start appropriate antibiotics is best because symptoms plus positive urinalysis support paediatric UTI. Provide only reassurance without clear follow-up or safety-netting is suboptimal because children can deteriorate quickly and follow-up must be explicit; Use adult dosing or adult pathways without paediatric adjustment is suboptimal because children require age- and weight-appropriate care; Delay assessment until the next routine visit is suboptimal because developmental, infectious and neonatal red flags require timely assessment; Give antibiotics, steroids or investigations routinely despite no indication is suboptimal because over-treatment can cause harm when supportive or targeted care is indicated. Urine collection method matters, especially in non-toilet-trained children.

Reference: Canadian Paediatric Society UTI statement