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 Vol. 18 No. 3, September 2007
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AAP Grand Rounds 18:25-26 (2007)
© 2007 American Academy of Pediatrics

UROLOGY

Does UTI Prophylaxis Cause More Harm Than Good?

Source: Conway PH, Cnaan A, Zaoutis T, et al. Recurrent urinary tract infections in children: Risk factors and association with prophylactic antimicrobials. JAMA. 2007;298:179–186; doi:10.1001/jama.298.2.179[Abstract/Free Full Text]

The first 20% of the full text of this article appears below.

The AAP currently recommends antimicrobial prophylaxis in young children with vesicoureteral reflux to prevent recurrent urinary tract infection (UTI).1 However, few studies have evaluated the risk factors for recurrent infections. In this study from the University of Pennsylvania, data were extracted from electronic health records of 27 diverse primary care pediatric practices in Delaware, New Jersey, and Pennsylvania. Among 74,974 children aged six years with at least two clinic visits between 2001 and 2006, the authors identified 775 with a diagnosis of UTI. After excluding children with prior UTI, observation time <24 days, presence of a chronic medical condition, and patients with UTI diagnosed only by bag urine specimen, 611 children remained for analysis.

UTI was defined as a urine culture with 50,000 cfu/mL or greater of a single organism. Patient characteristics evaluated to determine if they were risk factors for a recurrent UTI were: age at first UTI, gender, race, voiding cystourethrogram (VCUG) result, daily prophylactic antibiotic exposure, and other antibiotic exposure. For children experiencing recurrent UTI, these characteristics were also studied to identify risk factors for antibiotic . . . [Full Text of this Article]

Bernhard L. Weidermann, MD, FAAP
Children’s National Medical Center and George Washington University School of Medicine and Health Sciences, Washington, DC

 





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