Are routine urine cultures helpful in the management of asymptomatic infants or preschool children with a previous urinary tract infection

An asymptomatic 18 month old boy, undergoing radiological investigations after a urinary tract infection (UTI) diagnosed few months earlier, is reviewed at the clinic. According to departmental protocol, a three monthly urine culture should be submitted in infants and young children as, until the age of 4 years, they remain at risk of developing renal scars after UTIs. You wonder as to the value of this routine culture. In an asymptomatic infant or preschool child with a history of UTI under 4 years of age [patient] does the detection and management of asymptomatic bacteriuria (ABU) on routine urine culture [intervention] decrease the incidence of symptomatic UTI or renal scarring [outcomes]? Secondary sources—Cochrane Library (Issue 3, 2003): search words: (1) “urine culture” OR (2) “asymptomatic bacteriuria” OR (3) “urinary tract infection”. Database of systematic reviews: 32, 24, and 135 articles (for 1, 2, and 3 respectively), with 24, 14, and 101 complete reviews (for 1, 2, and 3 respectively). No relevant systematic review for under 4s. PubMed (1975–2003): search words—(“urine culture” OR “asymptomatic bacteriuria” OR “urinary tract infection”) AND (“prognosis” OR “renal …