Featured Research

from universities, journals, and other organizations

Prophylactic antibiotics prevent UTI recurrences in children with vesicoureteral reflux

Date:
May 4, 2014
Source:
American Academy of Pediatrics
Summary:
Children diagnosed with vesicoureteral reflux following a urinary tract infection (UTI) are at risk for kidney scarring with subsequent UTIs. New research shows that children receiving antimicrobials over a two-year period to prevent infections (antimicrobial prophylaxis) had a substantially reduced risk of UTI recurrences compared with children receiving a placebo.

Children diagnosed with vesicoureteral reflux (VUR) following a urinary tract infection (UTI) are at risk for kidney scarring with subsequent UTIs. New research shows that children receiving antimicrobials over a two-year period to prevent infections (antimicrobial prophylaxis) had a substantially reduced risk of UTI recurrences compared with children receiving a placebo.

Related Articles


The study was presented May 4, at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada. The study also is published in the New England Journal of Medicine on May 4.

Normally, urine flows only down from the kidneys to the bladder. VUR is the abnormal flow of urine from the bladder back up the tubes that connect the kidneys to the bladder. VUR is present in one-third of children presenting with urinary tract infection accompanied by a fever and has been associated with a heightened risk of kidney scarring.

Earlier randomized, controlled trials that compared anti-reflux surgery with antimicrobial prophylaxis showed no differences in rates of recurrent urinary tract infection and renal scarring; however, lack of a placebo or observation group precluded a determination that either surgery or prophylaxis was effective. Recently conducted randomized trials, most unblinded, have reported conflicting results about the effectiveness of antimicrobial prophylaxis in reducing recurrences.

The aim of this study was to determine if giving children low-dose trimethoprim-sulfamethoxazole would prevent recurrent UTIs, decrease kidney scarring and contribute to the emergence of bacterial resistance. Called the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) Trial, the study enrolled 607 children ages 2-71 months who were diagnosed with VUR following a first or second episode of UTI.

Participants were recruited from 19 clinical trial centers in the United States and underwent kidney scans to determine if scarring was present at baseline. Then they were randomized to receive trimethoprim-sulfamethoxazole or a placebo; kidney scans were repeated at one and two years.

Results showed that 39 of 302 children (13 percent) receiving antimicrobial prophylaxis developed UTIs compared to 72 of 305 (24 percent) receiving placebo. Antimicrobial prophylaxis reduced the risk of infections by 50 percent compared with placebo.

Prophylaxis was most effective in children who had a fever with their initial UTI and in those with bladder and bowel dysfunction at baseline. The occurrence of kidney scarring did not differ between the two groups (12 percent for the treatment group vs. 10 percent for the placebo group).

"Rates of renal scarring at the outcome visit were low and not reduced by prophylaxis, perhaps because most children were enrolled after their first infection and because parents, instructed to be vigilant, sought early medical attention," said lead author Alejandro Hoberman, MD, FAAP, chief of the Division of General Academic Pediatrics at Children's Hospital of Pittsburgh and professor of pediatrics at University of Pittsburgh School of Medicine. "Not unexpectedly, recurrences that did occur in children who received prophylaxis were more likely to have been caused by a resistant pathogen."

"This study showed unequivocal evidence that antimicrobial prophylaxis reduced at least in half the likelihood of children having recurrent UTIs," Dr. Hoberman concluded. "Some subgroups of children derived the most benefit, particularly those with bladder and bowel dysfunction at baseline, and those in whom the UTI occurred with fever."

To view the study abstract, go to http://www.abstracts2view.com/pas/view.php?nu=PAS14L1_2823.9&terms=.


Story Source:

The above story is based on materials provided by American Academy of Pediatrics. Note: Materials may be edited for content and length.


Cite This Page:

American Academy of Pediatrics. "Prophylactic antibiotics prevent UTI recurrences in children with vesicoureteral reflux." ScienceDaily. ScienceDaily, 4 May 2014. <www.sciencedaily.com/releases/2014/05/140504095506.htm>.
American Academy of Pediatrics. (2014, May 4). Prophylactic antibiotics prevent UTI recurrences in children with vesicoureteral reflux. ScienceDaily. Retrieved November 27, 2014 from www.sciencedaily.com/releases/2014/05/140504095506.htm
American Academy of Pediatrics. "Prophylactic antibiotics prevent UTI recurrences in children with vesicoureteral reflux." ScienceDaily. www.sciencedaily.com/releases/2014/05/140504095506.htm (accessed November 27, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Thursday, November 27, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Pet Dogs to Be Used in Anti-Ageing Trial

Pet Dogs to Be Used in Anti-Ageing Trial

Reuters - Innovations Video Online (Nov. 26, 2014) Researchers in the United States are preparing to discover whether a drug commonly used in human organ transplants can extend the lifespan and health quality of pet dogs. Video provided by Reuters
Powered by NewsLook.com
Today's Prostheses Are More Capable Than Ever

Today's Prostheses Are More Capable Than Ever

Newsy (Nov. 26, 2014) Advances in prosthetics are making replacement body parts stronger and more lifelike than they’ve ever been. Video provided by Newsy
Powered by NewsLook.com
From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

Newsy (Nov. 25, 2014) The US FDA is announcing new calorie rules on Tuesday that will require everywhere from theaters to vending machines to include calorie counts. Video provided by Newsy
Powered by NewsLook.com
Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Newsy (Nov. 25, 2014) Need another reason to eat yogurt every day? Researchers now say it could reduce a person's risk of developing type 2 diabetes. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins