Editor,—We read with interest the letter by Thayyil-Sudhan and Gupta reporting their study on the role of dipsticks in the detection of urinary tract infection in children.1We believe that this is a very important subject and wish to comment on the report and their conclusions in the light of our published study.2

We note that as 188 urine samples were not sent for culture, it is not possible to determine the number of true and false negative dipstick tests (if any). Without these data, calculation of sensitivity and specificity of dipstick testing becomes impossible.3Because of the above we believe that the data presented are skewed secondary to a flawed experimental design. Consequently, the statement of the authors that urinary tract infection in children cannot be excluded by a negative nitrite or leukocyte esterase reaction is difficult to justify. Furthermore, there is no information to indicate whether children who were being treated with antibiotics at or immediately before admission were included in the study. If this is the …