Do Prophylactic Antibiotics Prevent Recurrent Pyelonephritis in Children?

In a randomized, controlled trial, prophylaxis with trimethoprim/sulfamethoxazole did not reduce the rates of recurrent pyelonephritis or renal scarring.

Although widely promoted, the use of prophylactic antibiotics to prevent recurrent pyelonephritis in children with vesicoureteral reflux (VUR) is of questionable effectiveness. A recent study showed that such use served only to promote antibiotic resistance (JW Infect Dis Jul 25 2007). To reexamine the issue, researchers conducted an open-label, randomized, controlled trial at seven pediatric hospitals in Italy.

Participants — 100 children aged <30 months with grade II, III, or IV VUR that was diagnosed at the first episode of pyelonephritis — were randomly assigned to receive sulfamethoxazole/trimethoprim (5–10 mg/kg sulfamethoxazole and 1–2 mg/kg trimethoprim once daily), or no drug, for 2 years. Both groups were followed for 2 additional …

Reviewing Author

Robert S. Baltimore, MD

Disclosures

Editorial BoardsInfectious Diseases in Children

Leadership Positions in Professional SocietiesMember Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease

Robert S. Baltimore, MD

Disclosures

Editorial BoardsInfectious Diseases in Children

Leadership Positions in Professional SocietiesMember Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease

Do Prophylactic Antibiotics Prevent Recurrent Pyelonephritis in Children?

Topics

Reviewing Author