What are the recommended first-line antibiotics for treating uncomplicated UTIs in children?

Recommended first-line antibiotics for treating uncomplicated urinary tract infections (UTIs) in children over 3 months old are those aligned with the NICE guideline on urinary tract infection (lower): antimicrobial prescribing.

Specifically, for children over 3 months with lower UTI (cystitis), antibiotics should be prescribed according to the NICE antimicrobial prescribing guideline for lower UTI, which typically includes oral antibiotics such as nitrofurantoin or trimethoprim, depending on local resistance patterns and individual patient factors.

Babies and children under 3 months with suspected UTI should be referred immediately to a paediatric specialist and treated with parenteral antibiotics as per specialist guidance.

Antibiotics should not be used to treat asymptomatic bacteriuria in children.

Laboratories should monitor urinary pathogen resistance patterns to guide antibiotic choice.

Therefore, the first-line treatment for uncomplicated lower UTI in children over 3 months is oral nitrofurantoin or trimethoprim, following local antimicrobial resistance data and NICE recommendations.

Note: The exact antibiotic choice and duration should be confirmed by consulting the NICE guideline on urinary tract infection (lower): antimicrobial prescribing.

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