Girls and renal scarring as risk factors for febrile urinary tract infection after stopping antibiotic prophylaxis in children with vesicoureteral reflux

2021 ◽  
Author(s):  
Michiko Nakamura ◽  
Kimihiko Moriya ◽  
Masafumi Kon ◽  
Yoko Nishimura ◽  
Hiroki Chiba ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Prophylaxis ◽  
Vesicoureteral Reflux ◽  
Renal Scarring ◽  
Febrile Urinary Tract Infection

Antimicrobial Prophylaxis for Children With Vesicoureteral Reflux

2021 ◽  
pp. 257-262
Author(s):  
Philipp Dahm ◽  
Jane M. Lewis
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Prophylaxis ◽  
Vesicoureteral Reflux ◽  
Antimicrobial Prophylaxis ◽  
Renal Scarring ◽  
Symptomatic Urinary Tract Infection ◽  
Randomized Intervention ◽  
Tract Infections

This chapter summarizes the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial, a landmark trial that randomized children with vesicoureteral reflux diagnosed after a first or second febrile or symptomatic urinary tract infection to receive trimethoprim–sulfamethoxazole (TMP-SMX) prophylaxis versus placebo. It found that antibiotic prophylaxis reduced the incidence of recurrent febrile or symptomatic urinary tract infection but had little effect on renal scarring. Recurrent febrile or symptomatic urinary tract infections resistant pathogens were increased. This study provides the underpinning for guidelines that advocate for low-dose antibiotic prophylaxis for the first year of life; however, this remains an area of considerable controversy.

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