Prophylactic antibiotics in children at risk for urinary tract infection.
The outcome of using prophylactic antibiotics in children considered at risk for a urinary tract infection (UTI) was documented in 66 children during the period of suppressive antibiotics and for a follow-up period of 3.7+/-2.2 years (range 0.92-9.83 years). A breakthrough UTI occurred in 13 girls but none of the boys during the initial course of prophylactic antibiotics. During the follow-up period, 33 girls and 5 boys had no recurrence of infection, while 25 girls and 3 boys had UTIs. Statistical analysis of the data using chi-square and risk estimate relating factors for infection to the occurrence of a UTI showed that during the period of initial prophylactic antibiotic there was significant risk of infection among children with voiding dysfunction and abnormal kidneys and during the follow-up there was increased risk of infection among those with voiding dysfunction and vesicoureteric reflux (VUR) of grade 3 or greater severity. Lesser grades of VUR and constipation did not significantly increase the risk of UTI. These observations should be useful in developing a study to define the risks and benefits of prophylactic antibiotic in "at-risk" children.
Hellerstein
Stanley
S
Section of Nephrology, The Children's Mercy Hospital, The University of Missouri School of Medicine at Kansas City, 2401 Gillham Road, MO 64108, USA. shellers@cmh.edu
Nickell
Ellen
E
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011704:Pyelonephritis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D012307:Risk Factors; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D014718:Vesico-Ureteral Reflux / Q000517:prevention & control
D000900:Anti-Bacterial Agents