CURLY

Aimed at finding out the best number of days of cefalexin treatment for UTI

• Age 3 months to 11 years inclusive
• Clinical diagnosis of febrile UTI at presentation to ED as defined by BOTH:
• Temperature ≥38°C measured by any method or likely fever in the last 24 hours
• Clinical feature(s) suggestive of UTI at presentation – at least one symptom:




Under two years old:

Poor feeding Vomiting Irritability

Over two years old:

Vomiting Dysuria Urinary frequency Urinary urgency Abdominal or flank pain Suprapubic or flank tenderness



• Early urine test suggesting likely UTI as defined by any one of the following:
  
Dipstick: nitrite positive AND leucocyte esterase positiveDipstick: nitrite positive AND leucocyte esterase negative (on a fresh urine sample)Dipstick: leucocyte esterase positive AND nitrite negative AND the treating clinician assesses there to be good clinical evidence of a UTI (e.g. obvious urinary symptoms)Abnormal urine microscopy (bacteriuria by microscopy with Gram stain)
• Decision to treat with oral cefalexin
• Plan for discharge from the ED
• Able to give written informed consent and use the App

• Known congenital anomalies of the kidney and urinary tract (CAKUT), reflux nephropathy or indwelling catheter
• Known immune deficiency or currently receiving immunosuppression therapy
• Systemic antibiotics for any reason (treatment or prophylaxis) in the previous 14 days
• Weight > 50kg
• Known allergy to cefalexin or previous severe allergic reaction to any beta-lactam antibiotic
• The patient is on any other drug trial

• None