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Children’s Hospital of Pittsburgh of UPMC has developed a calculation tool that can assess the risk of urinary tract infections (UTI) in babies and toddlers, thereby reducing invasive testing and decreasing the number of missed cases.
Approximately 7 percent of the children younger than 2 who are brought to an emergency department with a fever have a UTI, which can cause serious complications if not treated properly. The tool, UTICalc, is described today in JAMA Pediatrics, and may reduce unnecessary catheterization and improve outcomes.
“UTICalc is an important tool because it can help reduce the delay in diagnosis and avoid unnecessary treatment with antimicrobial drugs,” said Nader Shaikh, M.D., M.P.H., lead author of the study and associate professor, Division of General Academic Pediatrics, Children’s Hospital. “Our approach tailors testing and treatment to the child’s risk factors, thus offering the potential to improve outcomes in children with UTI.”
The researchers studied 2,070 children with fevers, aged 2 months to 23 months who were seen at the Children’s Hospital emergency department over a six-year period. Each child had a documented temperature of 100.4°F or higher. By using UTICalc, clinicians reduced testing by 8.1 percent and decreased the number of misdiagnosed UTIs. The tool also reduced the number of children experiencing delays in starting antibiotics.
“We were able to fine tune the weighting of each UTI risk factor to better individualize testing and treatment recommendations,” said Timothy Shope, M.D., M.P.H., professor of pediatrics at Children's Hospital. “UTICalc gives the clinician an estimated risk of UTI before testing, then modifies that risk after incorporating the results of testing, facilitating clinician treatment decisions."
UTICalc is user-friendly, free and available online without a download.
Additional authors on the study are Alejandro Hoberman, M.D., Anastasia Alberty, B.S., Gysella Muniz, M.D., and Marcia Kurs-Lasky, M.S., all from Children’s Hospital of Pittsburgh of UPMC; Stephanie Hum, B.S., and Douglas Landsittel, Ph.D., from the University of Pittsburgh School of Medicine.
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