Antibiotic Prophylaxis For The Prevention Of Recurrent Urinary Tract Infection In Children With Low Grade Vesicoureteral Reflux

Main Category: Urology / Nephrology
Also Included In: Infectious Diseases / Bacteria / Viruses;  Pediatrics / Children's Health;  Clinical Trials / Drug Trials
Article Date: 23 Mar 2008 - 0:00 PST

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UroToday.com - A prospective study out of France evaluated the effectiveness of antibiotic prophylaxis in reducing the incidence of urinary tract infections in young children with low-grade vesicoureteral reflux, Grade I through Grade III. The group randomly assigned children 1 month to 3 years of age with Grade I to Grade III vesicoureteral reflux randomly to receive cotrimoxazole or no treatment. They followed these patients for 18 months. A breakthrough urinary tract infection constituted an exit criterion.

They had a total of 225 children enrolled in the study. The distribution of gender, age at inclusion, and reflux grade were similar between the two groups. There was no significant difference in the occurrence of urinary tract infection between these two groups. The study did show that prophylaxis significantly reduced urinary tract infection in boys and most notably in boys with Grade III vesicoureteral reflux. This data suggests that antibiotic prophylaxis does not reduce the overall incidence of urinary tract infection in children, however, it may be helpful in boys with high-grade reflux. It may have been further helpful to delineate whether the majority of these infections were all in the boys less than 1 year of age, as well as commenting on their circumcision status since boys with vesicoureteral reflux and an uncircumcised phallus might be at higher risk in the first year of life to urinary tract infection.

References: Roussey-Kesler G, Gadjos V, Indres N, Horen B, Ichay L, Leclair , Raymond F, Grellier A, Hazaret I, de Parscau L, Salomon R, Champion G, Leroy V, Guigonis V, Siret D, Palcoux JB, Taque S, Lemoigne A, Nguyen JM, Guyot C. Antibiotic prophylaxis for the prevention of recurrent urinary tract infection in children with low grade vesicoureteral reflux: Results from a prospective randomized study. The Journal of Urology. 179(2):674-679, February 2008.

Roussey-Kesler G, Gadjos V, Idres N, Horen B, Ichay L, Leclair MD, Raymond F, Grellier A, Hazart I, de Parscau L, Salomon R, Champion G, Leroy V, Guigonis V, Siret D, Palcoux JB, Taque S, Lemoigne A, Nguyen JM, Guyot C

Volume 179, Issue 2, Pages 674-679 (February 2008)
doi:10.1016/j.juro.2007.09.090

Reported by UroToday.com Medical Editor Pasquale Casale, MD Assistant Professor, University of Pennsylvania University of Pennsylvania, Children's Hospital of Philadelphia

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