Amazing Tool, UTICalc – When to Check UA in Kids

July 18, 2018

Written by Clay Smith

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This is amazing! UTICalc is an online tool that can both reduce unnecessary testing and missed UTIs.

Why does this matter?
In children aged 2-23 months, it can be hard to know when to check a UA.  Baseline prevalence in febrile children under age 2 years is 7%.  Obtaining a specimen with a catheter is a painful procedure, but missing a UTI is also risky.  Wouldn’t it be nice to custom tailor management for each patient?

My new favorite online calculator for pediatric UTI in children 2-23 months
This was a derivation and validation of an online UTI risk calculator for children aged 2 to 23 months.  UTICalc takes clinical variables to determine the risk (pretest probability) of UTI and whether or not a UA should be obtained.  If so, it then uses the UA characteristics to estimate the post-test probability of disease and need for antibiotic therapy.  It is a really great tool.  UTICalc was compared with the AAP guidelines (which do not have a fancy online calculator, by the way) and would have reduced testing by 8.4% and missed cases of UTI from 3 with the AAP rule to zero with UTICalc.  It is difficult to reduce both the testing rate and miss rate.  This means the tool helps us truly tailor the diagnostic workup in these children.  I highly recommend clicking on the UTICalc link and playing around with it.  This is ready to use in practice, in my opinion.

Source
Development and Validation of a Calculator for Estimating the Probability of Urinary Tract Infection in Young Febrile Children.  JAMA Pediatr. 2018 Jun 1;172(6):550-556. doi: 10.1001/jamapediatrics.2018.0217.
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Another Spoonful
Don’t Forget the Bubbles covered this article and more in their 18th Bubble Wrap.

Reviewed by Thomas Davis