Pediatric Infectious Disease

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VOLUME 1 , ISSUE 3 ( July-September, 2019 ) > List of Articles


Consensus and Controversies in Antibiotic Prophylaxis for Urinary Tract Infections

Rehna K Rahman, Nivedita Kamath

Keywords : Antibiotic prophylaxis, Urinary tract infection, Vesicoureteric reflux

Citation Information : Rahman RK, Kamath N. Consensus and Controversies in Antibiotic Prophylaxis for Urinary Tract Infections. Pediatr Inf Dis 2019; 1 (3):82-85.

DOI: 10.5005/jp-journals-10081-1203

License: CC BY-NC 4.0

Published Online: 05-09-2020

Copyright Statement:  Copyright © 2019; The Author(s).


Antibiotic prophylaxis in children with urinary tract infection (UTI) is controversial. There is some evidence to show that antibiotic prophylaxis reduces the risk of infection in children with vesicoureteric reflux (VUR) and recurrent UTI. However, there is also an increased risk of UTI by resistant organisms in children on long-term antibiotic prophylaxis. Little is known about the benefit of antibiotic prophylaxis in reducing the risk of scars and long-term sequelae of urinary tract infections.

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  1. Morello W, La Scola C, Alberici I, et al. Acute pyelonephritis in children. Pediatr Nephrol 2016;31(8):1253–1265. DOI: 10.1007/s00467-015- 3168-5.
  2. Shaikh N, Craig JC, Rovers MM, et al. Identification of children and adolescents at risk for renal scarring after a first urinary tract infection: a meta-analysis with individual patient data. JAMA Pediatr 2014;168(10):893–900. DOI: 10.1001/jamapediatrics. 2014.637.
  3. Calderon-Margalit R, Golan E, Twig G, et al. History of childhood kidney disease and risk of adult end-stage renal disease. N Engl J Med 2018;378(5):428–438. DOI: 10.1056/NEJMoa1700993.
  4. Indian Society of Pediatric Nephrology, Vijayakumar M, Kanitkar M, et al. Revised statement on management of urinary tract infections. Indian Pediatr 2011;48(9):709–717.
  5. Merrick MV, Notghi A, Chalmers N, et al. Long term follow up to determine the prognostic value of imaging after urinary tract infections. Part 1: reflux. Arch Dis Child 1995;72(5):388–392. DOI: 10.1136/adc.72.5.388.
  6. Dick PT, Feldman W. Routine diagnostic imaging for childhood urinary tract infections: a systematic overview. J Pediatr 1996;128(1):15–22. DOI: 10.1016/S0022-3476(96)70422-5.
  7. Song S-H, Kim KS. Antibiotic prophylaxis in pediatric urology. Indian J Urol 2008;24(2):145–149. DOI: 10.4103/0970-1591.40605.
  8. Brandström P, Hansson S. Long-term, low-dose prophylaxis against urinary tract infections in young children. Pediatr Nephrol 2014;30(3):425–432. DOI: 10.1007/s00467-014-2854-z.
  9. Antachopoulos C, Ioannidou M, Tratselas A, et al. Comparison of cotrimoxazole vs second-generation cephalosporins for prevention of urinary tract infections in children. Pediatr Nephrol 2016;31(12):2271–2276. DOI: 10.1007/s00467-016-3476-4.
  10. Roberts KB, Downs SM, Finnell SME, et al. Reaffirmation of aap clinical practice guideline: the diagnosis and management of the initial urinary tract infection in febrile infants and young children 2-24 months of age. Pediatrics 2016;138(6):e20163026. DOI: 10.1542/peds.2016-3026.
  11. Tekgül S, Riedmiller H, Hoebeke P, et al. EAU Guidelines on Vesicoureteral Reflux in Children. Eur Urol 2012;62(3):534–542. DOI: 10.1016/j.eururo.2012.05.059.
  12. NICE, National Collaborating Centre for Women's and Children's Health Urinary tract infection in children diagnosis, treatment and long-term management. RCOG Press; 2007.
  13. Sinha A, Bagga A, Krishna A, et al. Revised guidelines on management of antenatal hydronephrosis. Indian Pediatr 2013;50(2):215–231. DOI: 10.1007/s13312-013-0064-6.
  14. Clarke SA, Samuel M, Boddy S-A. Are prophylactic antibiotics necessary with clean intermittent catheterization? A randomized controlled trial. J Pediatr Surg 2005;40(3):568–571. DOI: 10.1016/ j.jpedsurg.2004.11.027.
  15. Carpenter MA, Hoberman A, Mattoo TK, et al. The rivur trial: profile and baseline clinical associations of children with vesicoureteral reflux. Pediatrics 2013;132(1):e34–e45. DOI: 10.1542/peds.2012-2301.
  16. Craig JC, Simpson JM, Williams GJ, et al. Antibiotic prophylaxis and recurrent urinary tract infection in children. N Engl J Med 2009;361(18):1748–1759. DOI: 10.1056/NEJMoa0902295.
  17. Brandström P, Esbjörner E, Herthelius M, et al. The swedish reflux trial in children: III. Urinary tract infection pattern. J Urol 2010;184(1): 286–291. DOI: 10.1016/j.juro.2010.01.061.
  18. Williams G, Craig JC. Long-term antibiotics for preventing recurrent urinary tract infection in children. Cochrane Database Syst Rev 2019;4:CD001534. DOI: 10.1002/14651858.CD001534.pub4.
  19. Larcombe J. Urinary tract infection in children: recurrent infections. BMJ Clin Evid 2015;2015:0306.
  20. Silay MS, Undre S, Nambiar AK, et al. Role of antibiotic prophylaxis in antenatal hydronephrosis: a systematic review from the European Association of Urology/European Society for Paediatric Urology Guidelines Panel. J Pediatr Urol 2017;13(3):306–315. DOI: 10.1016/ j.jpurol.2017.02.023.
  21. Herz D, Merguerian P, McQuiston L. Continuous antibiotic prophylaxis reduces the risk of febrile UTI in children with asymptomatic antenatal hydronephrosis with either ureteral dilation, high-grade vesicoureteral reflux, or ureterovesical junction obstruction. J Pediatr Urol 2014;10(4):650–654. DOI: 10.1016/j.jpurol.2014.06.009.
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