Is antibiotic prophylaxis in children with vesicoureteral reflux effective in preventing pyelonephritis and renal scars? A randomized, controlled trial. Export

@article{citeulike:2863506, abstract = {OBJECTIVES: There has been intense discussion on the effectiveness of continuous antibiotic prophylaxis for children with vesicoureteral reflux, and randomized, controlled trials are still needed to determine the effectiveness of long-term antibiotics for the prevention of acute pyelonephritis. In this multicenter, open-label, randomized, controlled trial, we tested the effectiveness of antibiotic prophylaxis in preventing recurrence of pyelonephritis and avoiding new scars in a sample of children who were younger than 30 months and vesicoureteral reflux. METHODS: One hundred patients with vesicoureteral reflux (grade II, III, or IV) diagnosed with cystourethrography after a first episode of acute pyelonephritis were randomly assigned to receive antibiotic prophylaxis with sulfamethoxazole/trimethoprim or not for 2 years. The main outcome of the study was the recurrence of pyelonephritis during a follow-up period of 4 years. During follow-up, the patients were evaluated through repeated cystourethrographies, renal ultrasounds, and dimercaptosuccinic acid scans. RESULTS: The baseline characteristics in the 2 study groups were similar. There were no differences in the risk for having at least 1 pyelonephritis episode between the intervention and control groups. At the end of follow-up, the presence of renal scars was the same in children with and without antibiotic prophylaxis. CONCLUSIONS: Continuous antibiotic prophylaxis was ineffective in reducing the rate of pyelonephritis recurrence and the incidence of renal damage in children who were younger than 30 months and had vesicoureteral reflux grades II through IV.}, address = {Clinica Pediatrica, Istituto per l'Infanzia IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34100 Trieste, Italy. pennesi@burlo.trieste.it}, author = {Pennesi, M. and Travan, L. and Peratoner, L. and Bordugo, A. and Cattaneo, A. and Ronfani, L. and Minisini, S. and Ventura, A. and {}}, citeulike-article-id = {2863506}, citeulike-linkout-0 = {http://dx.doi.org/10.1542/peds.2007-2652}, citeulike-linkout-1 = {http://pediatrics.aappublications.org/cgi/content/abstract/121/6/e1489}, citeulike-linkout-2 = {http://view.ncbi.nlm.nih.gov/pubmed/18490378}, citeulike-linkout-3 = {http://www.hubmed.org/display.cgi?uids=18490378}, doi = {10.1542/peds.2007-2652}, issn = {1098-4275}, journal = {Pediatrics}, keywords = {acute\_pyelonephritis, antibiotic\_prophylaxis, antibiotics, baseline\_characteristics, conclusions, control\_groups, cystourethrography, new\_scars, presence, prevention, randomized\_controlled\_trial, randomized\_controlled\_trials, recurrence, renal\_damage, risk, study\_groups, trimethoprim, ultrasounds}, month = {June}, number = {6}, posted-at = {2009-09-23 01:36:19}, priority = {2}, title = {Is antibiotic prophylaxis in children with vesicoureteral reflux effective in preventing pyelonephritis and renal scars? A randomized, controlled trial.}, url = {http://dx.doi.org/10.1542/peds.2007-2652}, volume = {121}, year = {2008} }

TY - JOUR ID - citeulike:2863506 L3 - citeulike-article-id:2863506 N2 - OBJECTIVES: There has been intense discussion on the effectiveness of continuous antibiotic prophylaxis for children with vesicoureteral reflux, and randomized, controlled trials are still needed to determine the effectiveness of long-term antibiotics for the prevention of acute pyelonephritis. In this multicenter, open-label, randomized, controlled trial, we tested the effectiveness of antibiotic prophylaxis in preventing recurrence of pyelonephritis and avoiding new scars in a sample of children who were younger than 30 months and vesicoureteral reflux. METHODS: One hundred patients with vesicoureteral reflux (grade II, III, or IV) diagnosed with cystourethrography after a first episode of acute pyelonephritis were randomly assigned to receive antibiotic prophylaxis with sulfamethoxazole/trimethoprim or not for 2 years. The main outcome of the study was the recurrence of pyelonephritis during a follow-up period of 4 years. During follow-up, the patients were evaluated through repeated cystourethrographies, renal ultrasounds, and dimercaptosuccinic acid scans. RESULTS: The baseline characteristics in the 2 study groups were similar. There were no differences in the risk for having at least 1 pyelonephritis episode between the intervention and control groups. At the end of follow-up, the presence of renal scars was the same in children with and without antibiotic prophylaxis. CONCLUSIONS: Continuous antibiotic prophylaxis was ineffective in reducing the rate of pyelonephritis recurrence and the incidence of renal damage in children who were younger than 30 months and had vesicoureteral reflux grades II through IV. IS - 6 JF - Pediatrics SN - 1098-4275 AD - Clinica Pediatrica, Istituto per l'Infanzia IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34100 Trieste, Italy. pennesi@burlo.trieste.it TI - Is antibiotic prophylaxis in children with vesicoureteral reflux effective in preventing pyelonephritis and renal scars? A randomized, controlled trial. VL - 121 KW - acute_pyelonephritis KW - antibiotic_prophylaxis KW - antibiotics KW - baseline_characteristics KW - conclusions KW - control_groups KW - cystourethrography KW - new_scars KW - presence KW - prevention KW - randomized_controlled_trial KW - randomized_controlled_trials KW - recurrence KW - renal_damage KW - risk KW - study_groups KW - trimethoprim KW - ultrasounds AU - Pennesi, M AU - Travan, L AU - Peratoner, L AU - Bordugo, A AU - Cattaneo, A AU - Ronfani, L AU - Minisini, S AU - Ventura, A PY - 2008/06// UR - http://dx.doi.org/10.1542/peds.2007-2652 ER -