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The 1999 American Academy of Pediatrics practice guideline recommends that children with a first urinary tract infection (UTI) undergo imaging to determine the presence and grade of vesicoureteral reflux, which is found in 30% to 40% of children with UTI. The guideline recommends that children with vesicoureteral reflux be given daily antibiotic prophylaxis to suppress recurrent UTI and, theoretically, to prevent renal scarring, but there is scant scientific support for this stance. Therefore, investigators sought to identify risk factors for recurrent UTI and resistant UTI and to assess the value of antibiotic prophylaxis against recurrent UTI in a cohort study of children 6 years or younger.
Among nearly 75,000 children seen at 27 primary …