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Is Antibiotic Prophylaxis in Children With Vesicoureteral Reflux Effective in Preventing Pyelonephritis and Renal Scars?
Department of Pediatrics, Institute of Child Health IRCCS Burlo Garofolo, Trieste, Italy
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 cystourethrography, renal ultrasounds, and dimercaptosuccinic acid scans.ar. There were no differences in the risk for having at least 1 pyelonephritis episode between the intervention and control groups. At the end of the 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.