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

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025Updated: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

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 .
  • Antibiotics are not recommended for asymptomatic bacteriuria in babies and children .
  • 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 .
  • Before prescribing antibiotics, consider taking microbiological samples if it is safe to delay treatment until results are available .
  • 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 .
  • When antibiotics are prescribed, document the indication, planned duration, and any relevant patient factors such as allergies or renal function .
  • Do not issue immediate antibiotics for likely self-limiting infections; consider delayed prescribing or self-care advice where appropriate .
  • Provide patients with verbal and written information on managing symptoms, when to seek further help, and the importance of completing antibiotic courses if prescribed .

Educational content only. Always verify information and use clinical judgement.