By the age of 7, some 8% of girls
and 2% of boys have had a urinary tract infection, and around one in 20 of
these will have renal damage. It is not known whether long-term antibiotic
prophylaxis prevents renal damage. Now, a multicenter trial in Australia has
shown that such prophylaxis prevents some reccurent urinary tract infections.
A 12-month randomized trial of
trimethoprim-sulfamethoxazole suspension vs placebo included 576 children (77%
<4 years old) with at least one previous urinary tract infection. Vesicoureteric
reflux had been diagnosed in 42%, reccurent urinary tract infection occurred during
the trial in 13% (treatment group) vs 19% (controls), a significant difference.
The number-needed-to-treat to prevent one urinary tract infection was 14.
Long term antibiotic prophylaxis
with trimethoprim-sulfamethoxazole was modestly effective.
JPOG MAR/APR 2010
Craig JC et al. Antibiotic
prophylaxis and reccurent urinary tract infection in children. NEJM 2009;
361:1748-1759; Hoberman A, Keren R, Antimicrobial prophylaxis for urinary tract
infection in children. Ibid: 1804-1806 (editorial).
regards, taniafdi ^_^
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