Open Access
Open access
American Medical Association (AMA)
JAMA network open
,  volume 7 ,  issue 11 ,  pages e2444495

Guidelines for the Prevention, Diagnosis, and Management of Urinary Tract Infections in Pediatrics and Adults

Zachary Nelson 1
, 
Abdullah Tarık Aslan 2
, 
Abdullah Tarık Aslan 2
, 
Nathan P Beahm 3
, 
Michelle Blyth 4
, 
Matthew Cappiello 5
, 
Danielle Casaus 6
, 
Fernando Dominguez 7
, 
Susan Egbert 8
, 
Alexandra Hanretty 9
, 
Tina Khadem 10
, 
Katie Olney 6
, 
Ahmed Abdul-Azim 11
, 
Gloria Aggrey 12
, 
Daniel T Anderson 13
, 
Mariana Barosa 14
, 
Michael Bosco 15
, 
Elias B Chahine 16
, 
Souradeep Chowdhury 17
, 
Alyssa Christensen 1
, 
Daniela de Lima Corvino 18
, 
Margaret Fitzpatrick 19
, 
Molly Fleece 18
, 
Brent Footer 20
, 
Emily Fox 21
, 
Bassam Ghanem 22
, 
Fergus Hamilton 23
, 
Justin Hayes 24
, 
Boris Jegorovic 25
, 
Philipp Jent 26
, 
Rodolfo Norberto Jimenez-Juarez 27
, 
Annie Joseph 28
, 
Minji Kang 29
, 
Geena Kludjian 9
, 
Sarah Kurz 30
, 
Rachael A. Lee 18
, 
Todd C Lee 31
, 
Timothy Li 32
, 
Alberto Enrico Maraolo 33
, 
Mira Maximos 34
, 
Emily G McDonald 31
, 
Dhara Mehta 35
, 
Justin William Moore 36
, 
William Justin Moore 36
, 
Cynthia T Nguyen 37
, 
Cihan Papan 38
, 
Akshatha Ravindra 39
, 
Brad Spellberg 40
, 
Robert Taylor 41, 42
, 
Alexis Thumann 43
, 
Steven Y. C. Tong 44, 45
, 
Michael Veve 46
, 
James Wilson 47
, 
Arsheena Yassin 48
, 
Veronica Zafonte 49
, 
Alfredo J. Mena Lora 50
1
 
HealthPartners and Park Nicollet Health Services, St Louis Park, Minnesota | 
2
 
3
 
4
 
5
 
Loma Linda University Medical Center, Loma Linda, California | 
6
 
7
 
Family Health Centers of San Diego, San Diego, California | 
8
 
9
 
Cooper University Health Care, Camden, New Jersey | 
10
 
11
 
12
 
Montgomery Medical Associates, Rockville, Maryland | 
13
 
Wellstar MCG Health, Augusta, Georgia | 
14
 
15
 
16
 
17
 
18
 
19
 
20
 
21
 
22
 
King Abdulaziz Medical City, Jeddah, Saudi Arabia | 
23
 
24
 
25
 
Clinic for Infectious and Tropical Diseases “Prof. Dr. Kosta Todorovic”, Belgrade, Serbia | 
26
 
27
 
28
 
29
 
30
 
31
 
32
 
33
 
34
 
35
 
Bellevue Hospital Center, Manhattan, New York, New York | 
36
 
Northwestern Medicine, Chicago, Illinois | 
37
 
38
 
39
 
40
 
Los Angeles General Medical Center, Los Angeles, California | 
41
 
Newfoundland and Labrador Health Services, St John’s, Newfoundland & Labrador, Canada | 
42
 
Memorial University, St. John’s, Newfoundland & Labrador, Canada | 
43
 
Mercy Medical Center, Cedar Rapids, Iowa | 
44
 
45
 
46
 
47
 
48
 
49
 
50
 
Publication type: Journal Article
Publication date: 2024-11-04
American Medical Association (AMA)
scimago Q1
wos Q1
SJR: 3.546
CiteScore: 13.8
Impact factor: 9.7
ISSN: 25743805
Abstract
Importance

Traditional approaches to practice guidelines frequently result in dissociation between strength of recommendation and quality of evidence.

Objective

To create a clinical guideline for the diagnosis and management of urinary tract infections that addresses the gap between the evidence and recommendation strength.

Evidence Review

This consensus statement and systematic review applied an approach previously established by the WikiGuidelines Group to construct collaborative clinical guidelines. In May 2023, new and existing members were solicited for questions on urinary tract infection prevention, diagnosis, and management. For each topic, literature searches were conducted up until early 2024 in any language. Evidence was reported according to the WikiGuidelines charter: clear recommendations were established only when reproducible, prospective, controlled studies provided hypothesis-confirming evidence. In the absence of such data, clinical reviews were developed discussing the available literature and associated risks and benefits of various approaches.

Findings

A total of 54 members representing 12 countries reviewed 914 articles and submitted information relevant to 5 sections: prophylaxis and prevention (7 questions), diagnosis and diagnostic stewardship (7 questions), empirical treatment (3 questions), definitive treatment and antimicrobial stewardship (10 questions), and special populations and genitourinary syndromes (10 questions). Of 37 unique questions, a clear recommendation could be provided for 6 questions. In 3 of the remaining questions, a clear recommendation could only be provided for certain aspects of the question. Clinical reviews were generated for the remaining questions and aspects of questions not meeting criteria for a clear recommendation.

Conclusions and Relevance

In this consensus statement that applied the WikiGuidelines method for clinical guideline development, the majority of topics relating to prevention, diagnosis, and treatment of urinary tract infections lack high-quality prospective data and clear recommendations could not be made. Randomized clinical trials are underway to address some of these gaps; however further research is of utmost importance to inform true evidence-based, rather than eminence-based practice.

Found 
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GOST |
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GOST Copy
Nelson Z. et al. Guidelines for the Prevention, Diagnosis, and Management of Urinary Tract Infections in Pediatrics and Adults // JAMA network open. 2024. Vol. 7. No. 11. p. e2444495.
GOST all authors (up to 50) Copy
Nelson Z. et al. Guidelines for the Prevention, Diagnosis, and Management of Urinary Tract Infections in Pediatrics and Adults // JAMA network open. 2024. Vol. 7. No. 11. p. e2444495.
RIS |
Cite this
RIS Copy
TY - JOUR
DO - 10.1001/jamanetworkopen.2024.44495
UR - https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2825634
TI - Guidelines for the Prevention, Diagnosis, and Management of Urinary Tract Infections in Pediatrics and Adults
T2 - JAMA network open
AU - Nelson, Zachary
AU - Tarık Aslan, Abdullah
AU - Aslan, Abdullah Tarık
AU - Beahm, Nathan P
AU - Blyth, Michelle
AU - Cappiello, Matthew
AU - Casaus, Danielle
AU - Dominguez, Fernando
AU - Egbert, Susan
AU - Hanretty, Alexandra
AU - Khadem, Tina
AU - Olney, Katie
AU - Abdul-Azim, Ahmed
AU - Aggrey, Gloria
AU - Anderson, Daniel T
AU - Barosa, Mariana
AU - Bosco, Michael
AU - Chahine, Elias B
AU - Chowdhury, Souradeep
AU - Christensen, Alyssa
AU - de Lima Corvino, Daniela
AU - Fitzpatrick, Margaret
AU - Fleece, Molly
AU - Footer, Brent
AU - Fox, Emily
AU - Ghanem, Bassam
AU - Hamilton, Fergus
AU - Hayes, Justin
AU - Jegorovic, Boris
AU - Jent, Philipp
AU - Jimenez-Juarez, Rodolfo Norberto
AU - Joseph, Annie
AU - Kang, Minji
AU - Kludjian, Geena
AU - Kurz, Sarah
AU - Lee, Rachael A.
AU - Lee, Todd C
AU - Li, Timothy
AU - Maraolo, Alberto Enrico
AU - Maximos, Mira
AU - McDonald, Emily G
AU - Mehta, Dhara
AU - Moore, Justin William
AU - Moore, William Justin
AU - Nguyen, Cynthia T
AU - Papan, Cihan
AU - Ravindra, Akshatha
AU - Spellberg, Brad
AU - Taylor, Robert
AU - Thumann, Alexis
AU - Tong, Steven Y. C.
AU - Veve, Michael
AU - Wilson, James
AU - Yassin, Arsheena
AU - Zafonte, Veronica
AU - Mena Lora, Alfredo J.
PY - 2024
DA - 2024/11/04
PB - American Medical Association (AMA)
SP - e2444495
IS - 11
VL - 7
PMID - 39495518
SN - 2574-3805
ER -
BibTex |
Cite this
BibTex (up to 50 authors) Copy
@article{2024_Nelson,
author = {Zachary Nelson and Abdullah Tarık Aslan and Abdullah Tarık Aslan and Nathan P Beahm and Michelle Blyth and Matthew Cappiello and Danielle Casaus and Fernando Dominguez and Susan Egbert and Alexandra Hanretty and Tina Khadem and Katie Olney and Ahmed Abdul-Azim and Gloria Aggrey and Daniel T Anderson and Mariana Barosa and Michael Bosco and Elias B Chahine and Souradeep Chowdhury and Alyssa Christensen and Daniela de Lima Corvino and Margaret Fitzpatrick and Molly Fleece and Brent Footer and Emily Fox and Bassam Ghanem and Fergus Hamilton and Justin Hayes and Boris Jegorovic and Philipp Jent and Rodolfo Norberto Jimenez-Juarez and Annie Joseph and Minji Kang and Geena Kludjian and Sarah Kurz and Rachael A. Lee and Todd C Lee and Timothy Li and Alberto Enrico Maraolo and Mira Maximos and Emily G McDonald and Dhara Mehta and Justin William Moore and William Justin Moore and Cynthia T Nguyen and Cihan Papan and Akshatha Ravindra and Brad Spellberg and Robert Taylor and Alexis Thumann and others},
title = {Guidelines for the Prevention, Diagnosis, and Management of Urinary Tract Infections in Pediatrics and Adults},
journal = {JAMA network open},
year = {2024},
volume = {7},
publisher = {American Medical Association (AMA)},
month = {nov},
url = {https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2825634},
number = {11},
pages = {e2444495},
doi = {10.1001/jamanetworkopen.2024.44495}
}
MLA
Cite this
MLA Copy
Nelson, Zachary, et al. “Guidelines for the Prevention, Diagnosis, and Management of Urinary Tract Infections in Pediatrics and Adults.” JAMA network open, vol. 7, no. 11, Nov. 2024, p. e2444495. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2825634.