title: The role of antimicrobial prophylaxis in the management of children with vesicoureteral reflux--the RIVUR study outcomes.
abstract: The role of antimicrobial prophylaxis for the prevention of recurrent urinary tract infections in children with vesicoureteral reflux that was identified following a urinary tract infection has been the source of considerable debate. Prior studies had failed to show a benefit in the prevention of recurrent infection. The National Institutes of Health funded the Randomized Intervention for Vesicoureteral Reflux (RIVUR) study to determine if there was a benefit to the use of prophylaxis. Results of the RIVUR study indicated that there was a 50% reduction in the risk of recurrent urinary tract infection in those children on the prophylaxis arm. Adverse events with the use of prophylaxis were noted to be few. Renal scarring was noted in only a small number of children at study entry and no reduction in scarring was noted between the placebo and the treated groups. The impact of the RIVUR study on the current evaluation and management of children with urinary tract infections and vesicoureteral reflux is detailed.
authors.affiliation: Departments of Surgery, Division of Urology and Pediatrics, Southern Illinois University School of Medicine, Springfield, IL; Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI; Division of Pediatric Nephrology and Hypertension, Children's Hospital of Michigan, Detroit, MI. Electronic address: rmathews94@siumed.edu.
authors.forename: Ranjiv
authors.initials: R
authors.lastname: Mathews
authors.affiliation: Departments of Surgery, Division of Urology and Pediatrics, Southern Illinois University School of Medicine, Springfield, IL; Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI; Division of Pediatric Nephrology and Hypertension, Children's Hospital of Michigan, Detroit, MI.
authors.forename: Tej K
authors.initials: TK
authors.lastname: Mattoo
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D002921:Cicatrix / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000517:prevention & control*; D012008:Recurrence; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*; D014552:Urinary Tract Infections / Q000209:etiology / Q000517:prevention & control*; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
keywords: Antimicrobial prophylaxis; Renal scarring; UTI; VUR