The incidence of TMP-SMX–resistant bacteria in recurrent infection was higher with TMP-SMX prophylaxis than with placebo but did not lead to more frequent recurrent urinary tract infections.
Recent placebo-controlled, randomized trial results showed that the use of trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis reduced the incidence of recurrent febrile or symptomatic urinary tract infection (UTI) in children (aged 2–71 months) with vesicoureteral reflux (NEJM JW Pediatr Adolesc Med May 21 2014; [e-pub] and N Engl J Med 2014; 370:2367). Now, researchers have examined patterns of antimicrobial resistance in recurrent symptomatic UTIs among trial participants.
Among 571 children (48% aged ≤1 year), 101 (18%) experienced recurrent symptomatic UTI during the 2-year follow-up. Most of the infections were caused by Escherichia coli (82%), and 45% of the children with recurrent infections had at least one with TMP-SMX resistance. …