title: Efficacy of Fluoroquinolone/Probiotic Combination Therapy for Recurrent Urinary Tract Infection in Children: A Retrospective Analysis.
abstract: OBJECTIVE
  Children with normal urinary tract anatomy and function and highly recurrent urinary tract infection (rUTI) may have a lack of alternatives when antibiotic prophylaxis and "watchful waiting" approaches fail. This retrospective review reports the outcomes in children who received a fluoroquinolone/probiotic combination in an attempt to quantify a reduction in rUTI that was perceived by both clinicians and patients' families.
  
  
  METHODS
  Data from all children with rUTIs previously managed with a fluoroquinolone/probiotic combination at the Pediatric Infectious Diseases Clinic at Duke University Medical Center (Durham, North Carolina) were identified and analyzed.
  
  
  RESULTS
  Data from 10 children were eligible for inclusion. Compared with before therapy initiation, total UTI episodes were significantly fewer after therapy initiation (57 vs 4; P = 0.0001). Seven (70%) were free of rUTIs during the follow-up period. Of the 8 patients with known compliance, 7 (88%) were free of rUTIs.
  
  
  CONCLUSIONS
  Given the chronic nature of these patients' symptoms, the significant decrease in UTI after the initiation of therapy, and the increase in the interval without an infection and/or its symptoms, this treatment regimen has the potential to improve overall quality of life, decrease antibiotic courses, and decrease health care costs in children with rUTI. These results will be validated with a larger cohort of patients in a prospective, randomized trial.
authors.affiliation: Division of Urologic Surgery and the Departments of.
authors.forename: Ramiro J
authors.initials: RJ
authors.lastname: Madden-Fuentes
authors.affiliation: Pediatrics.
authors.forename: Mehreen
authors.initials: M
authors.lastname: Arshad
authors.affiliation: Department of Urology, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Sherry S
authors.initials: SS
authors.lastname: Ross
authors.affiliation: Division of Urologic Surgery and the Departments of; Pediatrics; Molecular Genetics and Microbiology, Duke University Medical Center, Durham, North Carolina. Electronic address: patrick.seed@dm.duke.edu.
authors.forename: Patrick C
authors.initials: PC
authors.lastname: Seed
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D019936:Probiotics / Q000627:therapeutic use*; D011788:Quality of Life; D012008:Recurrence; D012189:Retrospective Studies; D055502:Secondary Prevention / Q000379:methods; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones
keywords: children; fluoroquinolone; probiotics; recurrent urinary tract infections