How should I interpret urine dipstick results in the context of suspected UTIs in children?

Interpreting urine dipstick results in children with suspected UTI:

• If both leukocyte esterase and nitrite are negative, assume the child does not have a UTI. Do not give antibiotics or send a urine sample for culture unless other risk criteria apply.
• If either leukocyte esterase or nitrite is positive, send the urine sample for culture and start antibiotics.
• For children aged 3 years or older, if both leukocyte esterase and nitrite are positive, assume UTI and give antibiotics; send urine for culture if the child has a high or intermediate risk of serious illness or previous UTI history.
• If leukocyte esterase is negative but nitrite is positive, give antibiotics if the sample is fresh and send for culture.
• If leukocyte esterase is positive but nitrite is negative, send urine for microscopy and culture but do not give antibiotics unless clinical evidence supports UTI.

Always use clinical judgement alongside dipstick results, especially if symptoms strongly suggest UTI but dipstick is negative, as false negatives can occur.