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Antibiotic Prophylaxis Linked to Lower Risk for Recurrent UTIs in Kids — Physician’s First Watch

Medical News |
May 5, 2014

Antibiotic Prophylaxis Linked to Lower Risk for Recurrent UTIs in Kids

By Kelly Young

Antibiotic prophylaxis is associated with fewer recurrences of urinary tract infection (UTI) in young children with vesicoureteral reflux, according to a New England Journal of Medicine study.

Over 600 children (aged 2 to 71 months) with vesicoureteral reflux diagnosed after their first or second UTI were randomized to receive either daily trimethoprim-sulfamethoxazole or placebo.

After 2 years, UTI recurrence was less common in the antibiotics group than the placebo group (26% vs. 37%). The authors estimate that eight children would need to be treated for 2 years to avoid one UTI. There was no significant difference between groups in renal scarring. Among patients with first recurrent UTI caused by E. coli, the proportion of resistant isolateswas higher in the antibiotics than the placebo group (63% vs. 19%).

Editorialists say that with the lack of difference in renal scarring, the threat of antibiotic resistance, and concerns about generalizability, more evidence is needed before universal adoption of prophylactic antibiotics.

Reader Comments (1)

Bill Rutenberg MD Physician, Pediatrics/Adolescent Medicine, Chicago

Ashamed that editorialists can't just eat crow, bite the bullet and admit they erred, which is human, rather than call for more studies.
This again shows the non evidence basis by which guidelines are written. It's the same error the experts made when they declared circumcision unusual punishment and then had to retract their position because incidence of urinary tract infections, sexually transmitted diseases, HIV included and penile cancer all statistically increased in uncircumcised males.
To bad it's still publish or perish.

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