American Academy of Pediatrics

View all recommendations from this society

Released March 17, 2014; updated July 13, 2016

Avoid the use of surveillance cultures for the screening and treatment of asymptomatic bacteriuria.

There is no evidence that surveillance urine cultures or treatment of asymptomatic bacteriuria is beneficial. Surveillance cultures are costly and produce both false positive and false negative results. Treatment of asymptomatic bacteriuria is harmful and increases exposure to antibiotics, which is a risk factor for subsequent infections with a resistant organism. This also results in the overall use of antibiotics in the community and may lead to unnecessary imaging.


These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The American Academy of Pediatrics (AAP) employed a three-stage process to develop its list. Using the Academy’s varied online, print and social media communication vehicles, the first stage invited leadership of the Academy’s 88 national clinical and health policy-driven committees, councils and sections to submit potential topics via an online survey. The second stage involved expert review and evaluation of the management groups that oversee the functions of the committees, councils and sections. Based on a set of criteria (evidence to document unproven clinical benefit, potential to cause harm, over-prescribed and utilized, and within the purview of pediatrics) a list of more than 100 topics was narrowed down to five. Finally, the list was reviewed and approved by the Academy’s Board of Directors and Executive Committee.

AAP’s disclosure and conflict of interest policy can be found at www.aap.org.

Sources

Kemper KJ, Avner ED. The case against screening urinalysis for asymptomatic bacteriuria in children. Am J Dis Child. 1992 Mar;146(3):343–6.

Nicolle LE. Asymptomatic bacteriuria: when to screen and when to treat. Infect Dis Clin North Am. 2003 Jun;17(2):367–94.

Roberts KB, Downs SM, Finnell SM, Hellerstein S, Shortliffe LD, Wald ER, Zerin JM.  American Academy of Pediatrics Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics.  Sep 2011;128(3):595–610.