Corticosteroids for Children With Febrile Urinary Tract Infections

Inclusion Criteria:

• Age: 2 months to 6 years

• Pyuria: ≥10 white blood cells per cubic millimeter (WBC/mm3) in an uncentrifugedspecimen or ≥5 white blood cells per high power field (WBC/hpf) in a centrifugedspecimen or ≥1+ leukocyte esterase (LE) on dipstick

• Fever: documented temperature of at least 101 °F or 38.3°C, measured anywhere on thebody either at home or at doctor's office within 24 hours of diagnosis

Exclusion Criteria:

• Other concurrent systemic bacterial infection(s) such as meningitis or pneumonia;

• Planned admission to intensive care unit;

• Known bacteremia;

• Previous protocol defined UTI;

• Known major urinary tract anomalies (severe hydronephrosis, ureterocele, urethralvalve, solitary or profoundly small kidney, multicystic dysplastic kidney, neurogenicbladder, pelvic or fused kidney);

• Congenital/acquired immunodeficiency;

• Bag urine collection

• Chronic diseases that could potentially interfere with response to therapy, such aschronic gastrointestinal conditions (i.e. malabsorption, inflammatory bowel disease),liver/kidney failure;

• Allergy to dexamethasone

• Antibiotic use within 7 days of enrollment (except if given in the last 48 hours)

• Systemic use of corticosteroids or other immunomodulating agents within 14 days ofenrollment

• History of Kawasaki disease

• Sickle cell disease (not trait)