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 Vol. 19 No. 5, May 2008
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AAP Grand Rounds 19:49-50 (2008)
© 2008 American Academy of Pediatrics

UROLOGY

Antibiotic Prophylaxis for Vesicoureteral Reflux Revisited

Source: Roussey-Kesler G, Gadjos V, Idres N, et al. Antibiotic prophylaxis for the prevention of recurrent urinary tract infection in children with low grade vesicoureteral reflux: results from a prospective randomized study. J Urol. 2008;179(2):674–679; doi:10.1016/j.juro.2007.09.090[Medline]

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


PICO*

Question: Among children 1 month to 3 years old with grade I to III vesicoureteral reflux, does daily cotrimoxazole prophylaxis reduce the incidence of urinary tract infection?

Question type: Treatment

Study design: Prospective, randomized trial

 

The management of low-grade vesicoureteral reflux (VUR) remains controversial. To determine if daily antimicrobial prophylaxis reduces the incidence of urinary tract infection (UTI) in young children with low-grade VUR, investigators from 17 pediatric centers in France studied 225 children between 1 and 36 months of age diagnosed with grade I–III VUR after febrile urinary infection.

One hundred and three children were randomized to daily prophylaxis with cotrimoxazole (10 mg/kg sulfamethoxazole and 2 mg/kg trimethoprim) and 122 received no treatment. Exclusion criteria included initial infection with a urinary pathogen resistant to cotrimoxazole, abnormal renal ultrasound, obstructive uropathy, and allergy to sulfonamides.

Dipstick urinalysis was performed in all children monthly and in any child with signs or symptoms of UTI. Urine was collected in . . . [Full Text of this Article]

Lane S. Palmer, MD, FAAP
Urology, Schneider Children’s Hospital, North Shore-Long Island Jewish Health System, Long Island, NY

 





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