Review: antibiotic prophylaxis may not prevent recurrent symptomatic urinary tract infection in children

2011 ◽  
Vol 96 (5) ◽  
pp. 198-198 ◽  
Author(s):  
G. Perez-Gaxiola
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Prophylaxis ◽  
Symptomatic Urinary Tract Infection

scholarly journals Antibiotic Prophylaxis with Trimethoprim-Sulfamethoxazole versus No Treatment after Mid-to-Distal Hypospadias Repair: A Prospective, Randomized Study

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Elizabeth B. Roth ◽  
John V. Kryger ◽  
Charles T. Durkee ◽  
Melissa A. Lingongo ◽  
Ruth M. Swedler ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Postoperative Complications ◽  
Tract Infection ◽  
Antibiotic Prophylaxis ◽  
Randomized Study ◽  
Hypospadias Repair ◽  
Symptomatic Urinary Tract Infection ◽  
Distal Hypospadias ◽  
The Impact

Purpose. To evaluate the impact of prophylactic antibiotics after distal hypospadias repair on postoperative bacteriuria, symptomatic urinary tract infection, and postoperative complications in a prospective, randomized trial. Materials and Methods. Consecutive patients aged 6 months to 2 years were enrolled at our institution between June 2013 and May 2017. Consenting patients were randomized to antibiotic prophylaxis with trimethoprim-sulfamethoxazole versus no antibiotic. Patients had catheterized urine samples obtained at surgery and 6–10 days postoperatively. The primary outcome was bacteriuria and pyuria at postoperative urine collection. Secondary outcomes included symptomatic urinary tract infection and postoperative complications. Results. 70 patients consented to the study, of which 35 were randomized to receive antibiotics compared to 32 who did not. Demographics, severity of hypospadias, and type of repair were similar between the groups. Patients in the treatment group had significantly less pyuria (18%) and bacteriuria (11%) present at stent removal compared to the nontreatment group (55% and 63%; p=0.01 and p<0.001, resp.). No patient had a symptomatic urinary tract infection. There were 11 postoperative complications. Conclusions. Routine antibiotic prophylaxis appears to significantly decrease bacteriuria and pyuria in the immediate postoperative period; however, no difference was observed in symptomatic urinary tract infection or postoperative complications. Clinical Trial Registration Number NCT02593903.

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.

The Benefits and Harms of Antibiotic Prophylaxis for Urinary Tract Infection in Older Adults

2021 ◽  
Author(s):  
Bradley J Langford ◽  
Kevin A Brown ◽  
Christina Diong ◽  
Alex Marchand-Austin ◽  
Kwaku Adomako ◽  
...  
Keyword(s):  
Older Adults ◽  
Urinary Tract Infection ◽  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Prophylaxis ◽  
Bloodstream Infection ◽  
Antibiotic Treatment ◽  
Positive Culture ◽  
Clostridioides Difficile

Abstract Background The role of antibiotics in preventing urinary tract infection (UTI) in older adults is unknown. We sought to quantify the benefits and risks of antibiotic prophylaxis among older adults. Methods We conducted a matched cohort study comparing older adults (≥66 years) receiving antibiotic prophylaxis, defined as antibiotic treatment for ≥30 days starting within 30 days of a positive culture, with patients with positive urine cultures who received antibiotic treatment but did not receive prophylaxis. We matched each prophylaxis recipient to 10 nonrecipients based on organism, number of positive cultures, and propensity score. Outcomes included (1) emergency department (ED) visit or hospitalization for UTI, sepsis, or bloodstream infection within 1 year; (2) acquisition of antibiotic resistance in urinary tract pathogens; and (3) antibiotic-related complications. Results Overall, 4.7% (151/3190) of UTI prophylaxis patients and 3.6% (n = 1092/30 542) of controls required an ED visit or hospitalization for UTI, sepsis, or bloodstream infection (hazard ratio [HR], 1.33; 95% confidence interval [CI], 1.12–1.57). Acquisition of antibiotic resistance to any urinary antibiotic (HR, 1.31; 95% CI, 1.18–1.44) and to the specific prophylaxis agent (HR, 2.01; 95% CI, 1.80–2.24) was higher in patients receiving prophylaxis. While the overall risk of antibiotic-related complications was similar between groups (HR, 1.08; 95% CI, .94–1.22), the risk of Clostridioides  difficile and general medication adverse events was higher in prophylaxis recipients (HR [95% CI], 1.56 [1.05–2.23] and 1.62 [1.11–2.29], respectively). Conclusions Among older adults with UTI, the harms of long-term antibiotic prophylaxis may outweigh their benefits.

Larger Numbers Needed

PEDIATRICS ◽  
1987 ◽  
Vol 80 (5) ◽  
pp. 764-764
Author(s):  
THOMAS E. WISWELL
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
First Year ◽  
Infection Rates ◽  
Symptomatic Urinary Tract Infection ◽  
Tract Infections ◽  
First Year Of Life

In Reply.— Dr Altschul presents data on urinary tract infections during infancy and reports infection rates substantially lower than those we have previously reported.1,2 He then makes several conclusions based on these differences. His data indicate that the maximum infection rates would be 0.11% among girls and 0.02% and 0.12% among circumcised and uncircumcised boys, respectively. In contrast, from a population of 422,328 infants, we found the overall incidence of symptomatic urinary tract infection during the first year of life to be 0.57% in girls, 0.11% in circumcised boys, and 1.12% in uncircumcised boys.

scholarly journals Correlation between uropathogenic properties ofEscherichia colifrom urinary tract infections and the antibody-coated bacteria test and comparison with faecal strains

1981 ◽  
Vol 87 (1) ◽  
pp. 53-61 ◽  
Author(s):  
Heather J. L. Brooks ◽  
Barbara A. Benseman ◽  
Jayne Peck ◽  
K. A. Bettelheim
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
World Literature ◽  
Symptomatic Urinary Tract Infection ◽  
E Coli ◽  
High K ◽  
Serotype 1 ◽  
H Serotypes ◽  
Tract Infections

SummaryStrains ofEscherichia coliisolated from adult females with symptomatic urinary tract infection were found to possess the following properties significantly more frequently than faecal strains: (i) high K-antigen titre; (ii) haemolysin; (iii) type 1 pili; (iv) mannose-resistant haemagglutination; (v) fermentation of dulcitol and salicin; (vi) O serotype 2, 6 and 75; (vii) H serotype 1.E. coliisolated from urine specimens containing significant numbers of antibody-coated bacteria were richer in these seven properties than strains from urines without detectable antibody-coated bacteria.The O and H serotypes ofE. coliobtained from patients with urinary tract infection in two New Zealand cities were compared with those reported in the world literature and found to be similar.

Sign in / Sign up

Export Citation Format

Share Document