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Antibiotic Prophylaxis for the Prevention of Recurrent Urinary Tract Infection in Children With Low Grade Vesicoureteral Reflux: Results From a Prospective Randomized Study

2007; Lippincott Williams & Wilkins; Volume: 179; Issue: 2 Linguagem: Inglês

10.1016/j.juro.2007.09.090

1527-3792

G. Roussey-Kesler, Vincent Gadjos, Nadia Idres, B. Horen, L. Ichay, Marc‐David Leclair, Frédérique Raymond, A. Grellier, I. Hazart, L de Parscau, Rémi Salomon, Gérard Champion, Valériane Leroy, Vincent Guigonis, Daniel Siret, Jean Bernard Palcoux, Sophie Taque, A. Lemoigne, Jean‐Michel Nguyen, C. Guyot,

Urinary Tract Infections Management

No AccessJournal of UrologyPediatric urology1 Feb 2008Antibiotic Prophylaxis for the Prevention of Recurrent Urinary Tract Infection in Children With Low Grade Vesicoureteral Reflux: Results From a Prospective Randomized Studyis accompanied byVesicoureteral Reflux: the RIVUR Study and the Way Forward G. Roussey-Kesler, V. Gadjos, N. Idres, B. Horen, L. Ichay, M.D. Leclair, F. Raymond, A. Grellier, I. Hazart, L. de Parscau, R. Salomon, G. Champion, V. Leroy, V. Guigonis, D. Siret, J.B. Palcoux, S. Taque, A. Lemoigne, J.M. Nguyen, and C. Guyot G. Roussey-KeslerG. Roussey-Kesler Medical Pediatric Clinic, Hospital Center and University of Nantes, Nantes, France More articles by this author , V. GadjosV. Gadjos Pediatric Services, Hospital Center of A. Beclere, Clamart, France More articles by this author , N. IdresN. Idres Hospital Center of Saint-Brieuc, Saint-Brieuc, France More articles by this author , B. HorenB. Horen Pediatric Nephrology Services, Hospital Center and University of Toulouse, Toulouse, France More articles by this author , L. IchayL. Ichay Hospital Center and University of Montpellier, Montpellier, France More articles by this author , M.D. LeclairM.D. Leclair Medical Pediatric Clinic, Hospital Center and University of Nantes, Nantes, France More articles by this author , F. RaymondF. Raymond Hospital Center of La Roche sur Yon, La Roche sur Yon, France More articles by this author , A. GrellierA. Grellier Hospital Center of Vannes, Vannes, France More articles by this author , I. HazartI. Hazart Medical Pediatric Clinic, Hospital Center and University of Nantes, Nantes, France More articles by this author , L. de ParscauL. de Parscau Hospital Center and University of Brest, Brest, France More articles by this author , R. SalomonR. Salomon Necker Hospital for Sick Children, Paris, France More articles by this author , G. ChampionG. Champion Hospital Center and University of Angers, Angers, France More articles by this author , V. LeroyV. Leroy Robert Debre Hospital, Paris, France More articles by this author , V. GuigonisV. Guigonis Hospital Center and University of Limoges, Limoges, France More articles by this author , D. SiretD. Siret Hospital Center of Saint Nazaire, Saint Nazaire, France More articles by this author , J.B. PalcouxJ.B. Palcoux Hospital Center and University of Clermont-Ferrand, Clermont-Ferrand, France More articles by this author , S. TaqueS. Taque Hospital Center and University of Rennes, Rennes, France More articles by this author , A. LemoigneA. Lemoigne Hospital Center of Lorient, Lorient, France More articles by this author , J.M. NguyenJ.M. Nguyen Biostatistics Department, Hospital Center and University of Nantes, Nantes, France More articles by this author , and C. GuyotC. Guyot Medical Pediatric Clinic, Hospital Center and University of Nantes, Nantes, France More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2007.09.090AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Antibiotic prophylaxis is given to children at risk for urinary tract infection. However, evidence concerning its effectiveness in grade I to III vesicoureteral reflux is lacking. The objective of this study was to determine whether antibiotic prophylaxis reduces the incidence of urinary tract infection in young children with low grade vesicoureteral reflux. Materials and Methods: Children 1 month to 3 years old with grade I to III vesicoureteral reflux were assigned randomly to receive daily cotrimoxazole or no treatment, and followed for 18 months. A urinary tract infection constituted an exit criterion. Infection-free survival rates were calculated using the Kaplan-Meier method and compared using the log rank test. Results: A total of 225 children were enrolled in the study. Distribution of gender, age at inclusion and reflux grade were similar between the 2 groups. There was no significant difference in the occurrence of urinary tract infection between the 2 groups (17% vs 26%, p = 0.2). However, a significant association was found between treatment and patient gender (p = 0.017). Prophylaxis significantly reduced urinary tract infection in boys (p = 0.013), most notably in boys with grade III vesicoureteral reflux (p = 0.042). Conclusions: These data suggest that antibiotic prophylaxis does not reduce the overall incidence of urinary tract infection in children with low grade vesicoureteral reflux. However, such a strategy may prevent further urinary tract infection in boys with grade III reflux. 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Dagorne, Delaperriere, Guest and Poignant, and Professors Bouissou and Morin participated in the study. Dr. Picherot critically read the manuscript, and Dr J. Ashton-Chess edited the manuscript.MetricsAuthor Information G. Roussey-Kesler Medical Pediatric Clinic, Hospital Center and University of Nantes, Nantes, France More articles by this author V. Gadjos Pediatric Services, Hospital Center of A. Beclere, Clamart, France More articles by this author N. Idres Hospital Center of Saint-Brieuc, Saint-Brieuc, France More articles by this author B. Horen Pediatric Nephrology Services, Hospital Center and University of Toulouse, Toulouse, France More articles by this author L. Ichay Hospital Center and University of Montpellier, Montpellier, France More articles by this author M.D. Leclair Medical Pediatric Clinic, Hospital Center and University of Nantes, Nantes, France More articles by this author F. Raymond Hospital Center of La Roche sur Yon, La Roche sur Yon, France More articles by this author A. Grellier Hospital Center of Vannes, Vannes, France More articles by this author I. Hazart Medical Pediatric Clinic, Hospital Center and University of Nantes, Nantes, France More articles by this author L. de Parscau Hospital Center and University of Brest, Brest, France More articles by this author R. Salomon Necker Hospital for Sick Children, Paris, France More articles by this author G. Champion Hospital Center and University of Angers, Angers, France More articles by this author V. Leroy Robert Debre Hospital, Paris, France More articles by this author V. Guigonis Hospital Center and University of Limoges, Limoges, France More articles by this author D. Siret Hospital Center of Saint Nazaire, Saint Nazaire, France More articles by this author J.B. Palcoux Hospital Center and University of Clermont-Ferrand, Clermont-Ferrand, France More articles by this author S. Taque Hospital Center and University of Rennes, Rennes, France More articles by this author A. Lemoigne Hospital Center of Lorient, Lorient, France More articles by this author J.M. Nguyen Biostatistics Department, Hospital Center and University of Nantes, Nantes, France More articles by this author C. Guyot Medical Pediatric Clinic, Hospital Center and University of Nantes, Nantes, France More articles by this author Expand All Advertisement PDF downloadLoading ...