Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Recommended guidelines for antibiotic use in urinary tract infections (UTIs) in primary care:
- Antibiotics should be prescribed for babies and children with suspected UTI according to age and severity: babies under 3 months with suspected UTI require immediate referral to a paediatric specialist and parenteral antibiotics, while children over 3 months with upper or lower UTI should receive antibiotics as per NICE antimicrobial prescribing guidelines for pyelonephritis or lower UTI respectively NICE NG224.
- Antibiotics are not recommended for asymptomatic bacteriuria in babies and children NICE NG224.
- Prophylactic antibiotics should not be routinely given following a first-time UTI in babies and children; prophylaxis is reserved for recurrent UTI cases as per specific guidelines NICE NG224.
- Before prescribing antibiotics, consider taking microbiological samples if it is safe to delay treatment until results are available NICE NG15.
- Discuss with patients or carers the nature of the infection, reasons for or against antibiotic use, alternative options, and safety-netting advice to support antimicrobial stewardship NICE NG15.
- When antibiotics are prescribed, document the indication, planned duration, and any relevant patient factors such as allergies or renal function NICE NG15.
- Do not issue immediate antibiotics for likely self-limiting infections; consider delayed prescribing or self-care advice where appropriate NICE NG15.
- Provide patients with verbal and written information on managing symptoms, when to seek further help, and the importance of completing antibiotic courses if prescribed NICE NG63.