title: Randomized Intervention for Children With Vesicoureteral Reflux (RIVUR): background commentary of RIVUR investigators.
abstract: Because of the frequency of urinary tract infections in children, off-label use of antimicrobial prophylaxis is often the usual treatment of children with vesicoureteral reflux, and such use is increasingly being called into question; hence, a definitive study to determine the value of antimicrobial prophylaxis with regard to the recurrence of urinary tract infection and the incidence of renal scarring is essential. The currently recommended follow-up procedures (repeated urine cultures, renal and genitourinary imaging, antimicrobial therapy and prophylaxis, as well as other factors including cleanliness, adequate bladder and bowel emptying, and compliance with protocols) are expensive (in terms of time, attention to detail, and cost) and cumbersome. Such recommendations should be evidence-based.
authors.affiliation: University of Tennessee Health Science Center, Department of Pediatrics, Memphis, TN 38103, USA. rchesney@utmem.edu
authors.forename: Russell W
authors.initials: RW
authors.lastname: Chesney
authors.forename: Myra A
authors.initials: MA
authors.lastname: Carpenter
authors.forename: Marva
authors.initials: M
authors.lastname: Moxey-Mims
authors.forename: Leroy
authors.initials: L
authors.lastname: Nyberg
authors.forename: Saul P
authors.initials: SP
authors.lastname: Greenfield
authors.forename: Alejandro
authors.initials: A
authors.lastname: Hoberman
authors.forename: Ron
authors.initials: R
authors.lastname: Keren
authors.forename: Ron
authors.initials: R
authors.lastname: Matthews
authors.forename: Tej K
authors.initials: TK
authors.lastname: Matoo
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000209:etiology / Q000517:prevention & control; D019468:Disease Management; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007223:Infant; D007668:Kidney / Q000473:pathology; D008297:Male; D015337:Multicenter Studies as Topic; D011704:Pyelonephritis / Q000473:pathology / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012107:Research Design; D019564:Unnecessary Procedures; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D014718:Vesico-Ureteral Reflux / Q000150:complications*
chemical_list: D000900:Anti-Bacterial Agents