[Synthesis of management of urinary tract infections in children].

Management of urinary tract infections (UTI) in children is at a crossroads both in regard to the diagnostic methods used, the need to detect vesico-ureteral reflux, the benefit of prophylactic antibiotics and the emergence strains of multiresistant E. coli. The Groupe de Pathologie Infectieuse Pédiatrique of French Society of Pediatrics takes position : (i) to utilize more frequently urinary dipsticks and for urinary cultures, other methods of urine sampling than bag (sample jet, urethral catheterization, supra-pubic puncture) ; (ii) do not alter the initial therapeutic proposals of the former AFSSAPS (despite the percentage of E. coli ESBL around 10 %), but now, as soon as possible to recover the result of susceptibility testing to quickly change (for effective antibiotic treatment against a resistant strain) and to increase the proportion of children receiving initial treatment with aminoglycosides monotherapy (which remains active on the majority of ESBL strains); (iii) to reduce the prescription of antibiotic prophylaxis and retrograde cystography, except in special circumstances (recurrence, major abnormalities on ultrasound).