• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Pediatrics

Antibiotic prophylaxis not associated with UTI prevention in children [Pediatrics Classics Series]

byLeah Carr, MDandLewis First, MD
October 18, 2014
in Pediatrics, Pediatrics Classics, The Classics
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

Image: PD

1. Among children recruited following febrile urinary tract infection (UTI) and randomized to receive either antibiotics or no medication, no significant difference in UTI recurrence was noted between groups.

2. Male children and those with grade III vesicoureteral reflex had significant reductions in subsequent UTIs if treated with prophylactic antibiotics.

Original Date of Publication: February 2008

Study Rundown: In the years leading up to this study, physicians often prescribed antibiotic prophylaxis to children at perceived increased risk for repeat urinary tract infections (UTIs), particularly those with vesicoureteral reflux (VUR). As multiple UTIs have been linked to renal scarring and nephropathy, preventing recurrence is highly important. However, with some studies indicating that antibiotics might be ineffective at preventing UTIs, this study took a prospective, randomized approach to investigate the effectiveness of prophylactic antibiotics in pediatric patients with mild VUR. This randomized, multi-center prospective study found no significant difference in repeat UTI among children with mild VUR who did or did not receive prophylactic antibiotics. A significant increase in risk for a second UTI was seen in those with grade III mild VUR and significant reduction in repeat UTI with treatment was observed in males. This study was limited in its lack of a blinded approach and placebo for control group “treatment” along with the use of potentially contaminated urine specimens from urine bags and uncircumcised males. It also lacked assessment for antibiotic compliance. This study raised questions regarding the necessity to prescribe prophylaxis for all young children following first febrile UTI and the need to obtain voiding cystourethrogram (VCUG) for all children in order to determine VUR presence. As unnecessary treatment is linked to potential adverse drug effects coupled with organism resistance, careful consideration should be taken in prescribing antimicrobial medication. In the time since this study’s publication, many more research projects have investigated UTI risk in children. The most recent American Academy of Pediatrics (AAP) practice guidelines for UTI management in young children are below and recommend renal and bladder ultrasound prior to VCUG and VCUG only if abnormal findings are found on ultrasound. Use of prophylactic antibiotics following initial UTI is not recommended, but potential further investigation of prophylaxis value among males with higher grade VUR is proposed.

Click to read the study in The Journal of Urology

Click to read the current AAP practice guidelines

RELATED REPORTS

#VisualAbstract: Oral antibiotic prophylaxis may reduce incidence of surgical site infections

#VisualAbstract: Cefepime/enmetazobactam superior to piperacillin/tazobactam for the treatment of complicated urinary tract infections and acute pyelonephritis

Management of uncomplicated urinary tract infections amongst women in the United States Military Health System highly concordant with guidelines

In-Depth [randomized, multi-center prospective study]: From June 2001 to December 2004, 225 patients (31% male) 1 month to 3 years of age with low grade VUR diagnosed on voiding cystourethrogram following febrile UTI were recruited from 17 French pediatric facilities. VUR was graded by severity into grade I, grade II, or grade III VUR and grouped by laterality (unilateral or bilateral). Participants were randomized to receive either trimethoprim (2 mg/kg)/sulfamethoxazole (10 mg/kg), also known today as Bactrim (n = 103, 46%), or no medication (n = 122, 54%). Follow-up renal ultrasound (US) was performed 9 and, 18 months after study initiation, both US and VCUG were completed. UTI was a study endpoint with children who experienced a UTI, defined as > 105 bacteria per mL of urine, excluded from the study and the UTI noted.

Following study initiation, 50 children, 18 in the treatment group (17%) and 32 in the control group (26%), experienced a second UTI. There was no significant difference between the two groups in terms of UTI rates (p = 0.15). There was also no significant difference between groups regarding the diagnosis of febrile UTI (13 or 13% in treatment group v. 19 or 16% of the control group, p = 0.52). The majority of UTI recurrence occurred in females (78%). Males who received prophylactic treatments had significantly less UTI than those who went untreated (39, 57% in untreated v. 30, 43% in treated, p < 0.05). This effect was not seen among females. No significant differences were seen between groups when analyzed by VUR grading or by VUR laterality. Multiregression analysis indicated that grade III VUR was a significant risk factor for repeat UTI (p < 0.01).

© 2013 2minutemedicine.com. All rights reserved. No works may be reproduced without expressed written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT. 

Tags: Antibiotic prophylaxisUTI
Previous Post

Repeat third trimester syphilis screening may not be cost effective

Next Post

2 Minute Medicine Rewind December 9 – December 15, 2013

RelatedReports

#VisualAbstract: Bepirovirsen may reduce disease burden in patients with chronic hepatitis B
StudyGraphics

#VisualAbstract: Oral antibiotic prophylaxis may reduce incidence of surgical site infections

December 15, 2022
#VisualAbstract: Cefepime/enmetazobactam superior to piperacillin/tazobactam for the treatment of complicated urinary tract infections and acute pyelonephritis
StudyGraphics

#VisualAbstract: Cefepime/enmetazobactam superior to piperacillin/tazobactam for the treatment of complicated urinary tract infections and acute pyelonephritis

October 13, 2022
Implementation of pneumococcal vaccine programs linked to decreased antibiotic prescription
Infectious Disease

Management of uncomplicated urinary tract infections amongst women in the United States Military Health System highly concordant with guidelines

August 8, 2022
Implementation of pneumococcal vaccine programs linked to decreased antibiotic prescription
Weekly Rewinds

2 Minute Medicine Rewind July 19, 2021

July 19, 2021
Next Post
Primary care and specialists have comparable outcomes in treating Sleep Apnea

2 Minute Medicine Rewind December 9 – December 15, 2013

Hypercortisolemia in ICU patients is due to reduced cortisol metabolism, not increased production

Pulse oximetry may overestimate oxygen saturation in PICU patients

AAP policy supports consumption of only pasteurized dairy products

AAP policy supports consumption of only pasteurized dairy products

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Bisphosphonates, denosumab, abaloparatide, teriparatide, and romosozumab reduce postmenopausal fracture risk
  • Epstein-Barr viral load monitoring reduces risk of post-liver transplant lymphoproliferative disease
  • Homicide deaths are on the rise for children living in the United States
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options