Featured Research

from universities, journals, and other organizations

Drug pair cuts children's urinary infections up to 80 percent

Date:
May 4, 2014
Source:
NIH/National Institute of Diabetes and Digestive and Kidney Diseases
Summary:
Long-term use of a drug combination reduces the risk of recurrent urinary tract infection by up to 80 percent in children with the urinary condition vesicoureteral reflux compared to placebo, according to research. In vesicoureteral reflux (VUR), developmental abnormalities in one or both ureters -- tubes connecting the kidneys with the bladder -- allow urine to flow back from the bladder into the ureters, and sometimes into the kidneys. VUR is found in 30-40 percent of children who have had a UTI, and is one of the most common urinary tract problems in children.

Vesicoureteral reflux is due to an abnormal, shortened ureter.
Credit: National Institute of Diabetes and Digestive and Kidney Diseases

Long-term use of a drug combination reduces the risk of recurrent urinary tract infection by up to 80 percent in children with the urinary condition vesicoureteral reflux compared to placebo, according to research funded by the National Institutes of Health. Results were published online May 4 in the New England Journal of Medicine to coincide with presentation at the Pediatric Academic Societies Annual Meeting in Vancouver, British Columbia.

In vesicoureteral reflux (VUR), developmental abnormalities in one or both ureters -- tubes connecting the kidneys with the bladder -- allow urine to flow back from the bladder into the ureters, and sometimes into the kidneys. VUR is found in 30-40 percent of children who have had a UTI, and is one of the most common urinary tract problems in children.

The risk of recurrent infection was cut by 50 percent in children with VUR using the drug combination trimethoprim/sulfamethoxazole (TMP/SMZ). Children with VUR and bladder and bowel dysfunction saw the greatest reduction, up to an 80 percent lower risk of recurrent infections. This group is also more likely to have recurrent urinary infections, which can increase the risk of kidney scarring and the potential for kidney failure.

For decades, doctors have treated children who have VUR with a small daily dose of TMP/SMZ -- often for years, in hopes of preventing recurrent UTIs and kidney damage. The Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial provides the first conclusive clinical evidence for the effectiveness of this practice. It studied a well-defined population of children compared to earlier studies, included a placebo group, used digital imaging, and showed a strong response to treatment.

"We are looking deeper into the data from the RIVUR trial to gain further insight into other factors that may reduce susceptibility to recurrent infections and scarring," said Dr. Marva Moxey-Mims, a pediatric kidney specialist at the NIH's National Institute of Diabetes and Digestive and Kidney Diseases, the study's primary funder. "In the meantime, we can buy children some time with fewer infections, allowing many of them to outgrow reflux as their bodies develop and mature."

While TMP/SMZ significantly reduced recurrent infections, the number of children who developed kidney scarring did not drop. The researchers suggest this may be due to parents' heightened vigilance for UTI symptoms and early treatment in the trial and that most of the children were enrolled after their first infection rather than after multiple infections, when more scarring might occur.

"We also saw some increased antimicrobial resistance, which researchers are looking at more closely," Moxey-Mims said. "However, until we have those results, the use of these drugs appears to provide more benefit than risk in these children."

RIVUR was a two-year clinical trial that randomized 607 children to receive the TMP/SMP drug combination or placebo. The study was conducted in 19 locations across the United States and coordinated by the University of North Carolina at Chapel Hill.


Story Source:

The above story is based on materials provided by NIH/National Institute of Diabetes and Digestive and Kidney Diseases. Note: Materials may be edited for content and length.


Journal Reference:

  1. Julie R. Ingelfinger, F. Bruder Stapleton. Antibiotic Prophylaxis for Vesicoureteral Reflux — Answers, Yet Questions. New England Journal of Medicine, 2014; 140504000112001 DOI: 10.1056/NEJMe1404774

Cite This Page:

NIH/National Institute of Diabetes and Digestive and Kidney Diseases. "Drug pair cuts children's urinary infections up to 80 percent." ScienceDaily. ScienceDaily, 4 May 2014. <www.sciencedaily.com/releases/2014/05/140504095515.htm>.
NIH/National Institute of Diabetes and Digestive and Kidney Diseases. (2014, May 4). Drug pair cuts children's urinary infections up to 80 percent. ScienceDaily. Retrieved July 31, 2014 from www.sciencedaily.com/releases/2014/05/140504095515.htm
NIH/National Institute of Diabetes and Digestive and Kidney Diseases. "Drug pair cuts children's urinary infections up to 80 percent." ScienceDaily. www.sciencedaily.com/releases/2014/05/140504095515.htm (accessed July 31, 2014).

Share This




More Health & Medicine News

Thursday, July 31, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Health Insurers' Profits Slide

Health Insurers' Profits Slide

Reuters - Business Video Online (July 30, 2014) Obamacare-related costs were said to be behind the profit plunge at Wellpoint and Humana, but Wellpoint sees the new exchanges boosting its earnings for the full year. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
Concern Grows Over Worsening Ebola Crisis

Concern Grows Over Worsening Ebola Crisis

AFP (July 30, 2014) Pan-African airline ASKY has suspended all flights to and from the capitals of Liberia and Sierra Leone amid the worsening Ebola health crisis, which has so far caused 672 deaths in Guinea, Liberia and Sierra Leone. Duration: 00:43 Video provided by AFP
Powered by NewsLook.com
At Least 20 Chikungunya Cases in New Jersey

At Least 20 Chikungunya Cases in New Jersey

AP (July 30, 2014) At least 20 New Jersey residents have tested positive for chikungunya, a mosquito-borne virus that has spread through the Caribbean. (July 30) Video provided by AP
Powered by NewsLook.com
Xtreme Eating: Your Daily Caloric Intake All On One Plate

Xtreme Eating: Your Daily Caloric Intake All On One Plate

Newsy (July 30, 2014) The Center for Science in the Public Interest released its 2014 list of single meals with whopping calorie counts. 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:
from the past week

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