A dipstick urinalysis is positive for leukocyte esterase and nitrites in a school-age child with dysuria and foul-smelling urine but no fever who has not had previous urinary tract infections. A culture is pending. What will the pediatric nurse practitioner do to treat this child?

Question

Quizplus · Accepted Answer

The presence of leukocyte esterase and nitrites on a dipstick urinalysis is highly indicative of a urinary tract infection. In the absence of fever, a shorter course of antibiotics (3-5 days) can be used. Trimethoprim-sulfamethoxazole (TMP) is a commonly used first-line agent for uncomplicated urinary tract infections in children. Waiting for culture results is not necessary if the child has symptoms consistent with a UTI, and ciprofloxacin ER is not recommended as a first-line agent in younger children. Asymptomatic bacteriuria is possible in certain populations, but this child has symptoms and a positive dipstick, making a UTI more likely.

A Dipstick Urinalysis Is Positive for Leukocyte Esterase and Nitrites