What are the recommended guidelines for the use of antibiotics in the treatment of urinary tract infections in primary care?

Recommended guidelines for antibiotic use in urinary tract infections (UTIs) in primary care:

• Antibiotics should be prescribed for babies and children with suspected UTI according to age and severity: babies under 3 months with suspected UTI require immediate referral to a paediatric specialist and parenteral antibiotics, while children over 3 months with upper or lower UTI should receive antibiotics as per NICE antimicrobial prescribing guidelines for pyelonephritis or lower UTI respectively ¹.
• Antibiotics are not recommended for asymptomatic bacteriuria in babies and children ¹.
• Prophylactic antibiotics should not be routinely given following a first-time UTI in babies and children; prophylaxis is reserved for recurrent UTI cases as per specific guidelines ¹.
• Before prescribing antibiotics, consider taking microbiological samples if it is safe to delay treatment until results are available ².
• Discuss with patients or carers the nature of the infection, reasons for or against antibiotic use, alternative options, and safety-netting advice to support antimicrobial stewardship ².
• When antibiotics are prescribed, document the indication, planned duration, and any relevant patient factors such as allergies or renal function ².
• Do not issue immediate antibiotics for likely self-limiting infections; consider delayed prescribing or self-care advice where appropriate ².
• Provide patients with verbal and written information on managing symptoms, when to seek further help, and the importance of completing antibiotic courses if prescribed ³.