Repeat Urine Cultures in Children Who Are Admitted With Urinary Tract Infections

Urinary tract infections are a common cause of hospitalization in the pediatric population. Hospitalization for urinary tract infections in children usually involves intravenous antibiotics, invasive methods of obtaining sterile urine specimens, and imaging studies to assess the anatomy of the urinary system. The objective of this study was to determine the frequency of positive repeat urine cultures that are obtained after 2 days of antibiotics among pediatric inpatients who are admitted with diagnosed or suspected infections of the urinary tract. A retrospective survey was conducted of all pediatric patients (< or = 18 years of age) who were admitted to Elmhurst Hospital in Queens, New York, with a suspected or diagnosed urinary infection from December 1998 through December 2004. Results of repeat urine cultures that were obtained after 2 days of antibiotics were abstracted from a computerized medical charts database. Nominal data analysis was used to establish the frequency of positive repeat urine cultures. A total of 328 (54.8%) of 599 eligible admissions met inclusion criteria. Of these 328 admissions, only 1 (0.3%) repeat urine culture was positive after 2 days of antimicrobial therapy. Positive repeat urine cultures after 2 days of antibiotics are exceedingly rare. Elimination of mandatory "proof-of-bacteriologic-cure" benchmarks before hospital discharge is supported by this study.