Febrile Infant Clinical Pathway – Emergency Department and Inpatient – Diagnostic Imaging and Prophylactic Antibiotics

Febrile Infant Clinical Pathway – Emergency Department and Inpatient

Diagnostic Imaging and Prophylactic Antibiotics

  Renal Bladder Ultrasound (RBUS) Voiding Cysto-Urethrogram (VCUG)1 Urology Consult Prophylactic Antibiotics
1st UTI All patients If RBUS is abnormal
or as clinically indicated2		 All preterm infants or N/IICU patients

In healthy, full-term infant on IP unit:
If RBUS is abnormal or as clinically indicated2		 Not routinely indicated
≥ 2nd UTI Recommended for all patients regardless of RBUS results All patients Discuss prophylaxis with urology
  1. In select infants a contrast-enhanced voiding urosonography (ceVUS) can be considered.
  2. In case of severe illness, consider a VCUG and urology consult even if the RBUS is normal. This may include prolonged clinical instability, AKI, gross hematuria, etc.

Consider Urology Consult

In healthy full-term infants on inpatient unit with first UTI and NORMAL RBUS, consider Urology consult for any concern for underlying risk factors or as clinically indicated (prolonged clinical instability, AKI, gross hematuria, etc.).

VCUG as Clinically Indicated

  • Urology consult recommended if considering VCUG
  • In select infants, a Contrast-enhanced Voiding Urosonography (ceVUS) can be considered.