Long-term antibiotics for the prevention of recurrent urinary tract infection in children: a systematic review and meta-analysis

@article{Dai2010LongtermAF,
  title={Long-term antibiotics for the prevention of recurrent urinary tract infection in children: a systematic review and meta-analysis},
  author={Bing Dai and Yawei Liu and Jieshuang Jia and Changlin Mei},
  journal={Archives of Disease in Childhood},
  year={2010},
  volume={95},
  pages={499 - 508}
}
Objective To evaluate the effectiveness and safety of long-term prophylactic antibiotics for recurrent urinary tract infection (UTI) in children through meta-analysis of randomised controlled trials. Methods Electronic databases and reference lists of review articles were searched for relevant trials. Outcome measures were recurrence of symptomatic UTI, repeat positive urine culture, new or deteriorated renal scarring and adverse events during and after treatment. Results Eleven trials with… Expand
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Citation Type

Long-term antibiotics for preventing recurrent urinary tract infection in children.
TLDR
Long-term antibiotics appear to reduce the risk of repeat symptomatic UTI in susceptible children but the benefit is small and must be considered together with the increased risk of microbial resistance. Expand
Current status of long-term antibiotic prophylaxis for urinary tract infections in children: An antibiotic stewardship challenge
TLDR
No conclusive evidence can be drawn from the available clinical data to support routine use of CAP for prevention of renal scarring and the efficacy of CAP remains unclear due to non-generalizability of results obtained from suboptimally designed clinical trials. Expand
Combination of Probiotics and Antibiotics in the Prevention of Recurrent Urinary Tract Infection in Children
TLDR
The consumption of probiotic and antibiotics in children with RUTI is safe and more effective in reducing the incidence of febrile UTI in comparison to prophylactic antibiotics alone. Expand
Breakthrough Urinary Tract Infection: A Clinical Study of Experience of a Single Center
TLDR
P preexisting renal scar might be one of the factors which should be considered in favor of early surgical interventions of VUR, based on the study results. Expand
Causes of Recurrent Urinary Tract Infection in Children on Prophylaxis
TLDR
It is concluded that girls are at higher risk of recurrent infection and regarding the high prevalence of Co-trimoxazole resistance, administration of this drug should be limited and with caution. Expand
Urinary Infection Recurrence and Its Related Factors in Urinary Tract Infection
TLDR
There was no difference regarding age, gender, dysfunctional elimination syndrome, and urine culture inChildren with recurrent UTI compared to those with first UTI, yet abnormal VCUG, kidney, and urinary tract ultrasonography were much more common in children with recurrentUTI. Expand
Evaluation and management of urinary tract infections in the neonate
  • R. Beetz
  • Medicine
  • Current opinion in pediatrics
  • 2012
TLDR
Main objectives in the management of neonatal UTIs are the prevention of acute infection-related complications and renal damage and the detection of risk factors. Expand
Clinical Options for the Treatment of Urinary Tract Infections in Children
TLDR
Local formularies should reflect geographical resistance patterns along with best evidence on the duration and choice of antibiotic in order to maximize therapeutic effect, while minimizing the development of resistant strains. Expand
Management of urinary tract infection in a tertiary children's hospital before and after publication of the NICE guidelines
TLDR
While the reduction in MCUG requests and prescription of antibiotic prophylaxis is in line with NICE guidelines, the increase in DMSA requests is contrary to the recommendations. Expand
Antibiotic prophylaxis reduced symptomatic urinary tract infection in children with vesicoureteral reflux, but not scarring
  • G. Pérez-Gaxiola
  • Medicine
  • Archives of Disease in Childhood: Education & Practice Edition
  • 2014
TLDR
Results are both encouraging and disappointing: prophylaxis reduces symptomatic UTI recurrence in children with VUR by 12%, but does not reduce renal scarring, hospitalisations or emergency room visits. Expand
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References

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Antibiotics for the prevention of urinary tract infection in children: A systematic review of randomized controlled trials.
  • G Williams, A Lee, J. Craig
  • Medicine
  • The Journal of pediatrics
  • 2001
TLDR
There is considerable uncertainty about whether long-term, low-dose antibiotic administration prevents UTI in children and well-designed, randomized, placebo-controlled trials are still required to evaluate this commonly used intervention. Expand
Long-term antibiotics for preventing recurrent urinary tract infection in children.
TLDR
Long-term antibiotics appear to reduce the risk of repeat symptomatic UTI in susceptible children but the benefit is small and must be considered together with the increased risk of microbial resistance. Expand
Antibiotic prophylaxis and recurrent urinary tract infection in children.
TLDR
Long-term, low-dose trimethoprim-sulfamethoxazole therapy was associated with a decreased number of urinary tract infections in predisposed children, and the treatment effect appeared to be consistent but modest across subgroups. Expand
Long-term antibiotics for preventing recurrent urinary tract infection in children.
TLDR
Large, properly randomised, double blinded trials are needed to determine the efficacy and side effects of long-term antibiotics given to prevent recurrent UTI in susceptible children. Expand
Prophylaxis After First Febrile Urinary Tract Infection in Children? A Multicenter, Randomized, Controlled, Noninferiority Trial
TLDR
For children with or without primary nonsevere reflux, prophylaxis does not reduce the rate of recurrent febrile urinary tract infections after the first episode, and Bivariate analysis and Cox proportional hazard model showed that grade III reflux was a risk factor for recurrent febs. Expand
Antibiotic prophylaxis for the prevention of recurrent urinary tract infection in children with low grade vesicoureteral reflux: results from a prospective randomized study.
TLDR
It is suggested that antibiotic prophylaxis does not reduce the overall incidence of urinary tract infection in children with low grade vesicoureteral reflux, however, such a strategy may prevent further urinary tract infections in boys with grade III reflux. Expand
Clinical Significance of Primary Vesicoureteral Reflux and Urinary Antibiotic Prophylaxis After Acute Pyelonephritis: A Multicenter, Randomized, Controlled Study
TLDR
After 1 year of follow-up monitoring, mild/moderate VUR does not increase the incidence of UTI, pyelonephritis, or renal scarring after acute pyel onephritis and a role for urinary antibiotic prophylaxis in preventing the recurrence of infection and the development of renal scars is not supported by this study. Expand
CONTROLLED TRIAL OF PROPHYLACTIC TREATMENT IN CHILDHOOD URINARY-TRACT INFECTION
TLDR
Differences in symptomatology and timing of reinfections and possible contributory factors are discussed, and 68% of the prophylactic group and 36% of those who received noProphylaxis were recurrence-free. Expand
Is Antibiotic Prophylaxis in Children With Vesicoureteral Reflux Effective in Preventing Pyelonephritis and Renal Scars? A Randomized, Controlled Trial
TLDR
Continuous antibiotic prophylaxis was ineffective in reducing the rate of pyelonephritis recurrence and the incidence of renal damage in children who were younger than 30 months and had vesicoureteral reflux grades II through IV. Expand
Recurrent urinary tract infections in children: risk factors and association with prophylactic antimicrobials.
TLDR
Among the children in this study, antimicrobial prophylaxis was not associated with decreased risk of recurrent UTI, but was associated with increased risk of resistant infections. Expand
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