The Outcome of Stopping Prophylactic Antibiotics in Older Children With Vesicoureteral Reflux

Cooper, Christopher S.; Chung, Benjamin I.; Kirsch, Andrew J.; Canning, Douglas A.; Snyder, Howard M.

doi:10.1097/00005392-200001000-00077

Cited by 21 publications

(26 citation statements)

References 23 publications

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“…According to these studies, discontinuation of CAP after being toilet-trained seems safe [3,[5][6][7][8]. Cooper et al [5] were the first to report the outcome regarding discontinuation of CAP for children with VUR. They observed 51 children with persistent VUR for an average of 3.7 years.…”

Section: Discussion/conclusionmentioning

confidence: 99%

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Retrospective Analysis to Determine the Optimal Timing to Discontinue Continuous Antibiotic Prophylaxis in Patients with Primary Vesicoureteral Reflux

et al. 2019

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Background: The management of febrile urinary tract infection (fUTI) in patients with vesicoureteral reflux (VUR) is crucial to prevent renal scarring. Continuous antibiotic prophylaxis (CAP) is the most widely used initial treatment for VUR. However, the optimal duration of CAP is still unclear. We aimed to clarify an appropriate patient population and the optimal timing to discontinue CAP. Methods: We reviewed the records of 247 patients with primary VUR between January 2000 and December 2015. Seventy-two patients who discontinued CAP despite persistent VUR were enrolled. Kaplan-Meier method and Cox proportional hazard model was used in statistical analysis. Results: Following the discontinuation of CAP, fUTI developed in 25 patients after a median of 9 months (range 0–81). VUR resolved spontaneously in 9 out of 47 patients without recurrence during follow-up. Multivariate analysis showed bilateral VUR and duration of CAP of less than 1 year after the last fUTI were significant risk factors for recurrence. Conclusion: Among the risk factors examined, patients administered CAP for less than 1 year after the last fUTI and those with bilateral VUR had significantly more frequent recurrence. Our study suggests that the administration of CAP for more than 1 year after the last fUTI is beneficial in avoiding recurrent fUTI.

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Section: Discussion/conclusionmentioning

confidence: 99%

“…Discontinuation of CAP after being toilettrained is generally recommended [18] because several studies have reported good outcomes [3,[5][6][7][8]. However, other recommended timings for discontinuation of CAP is not well documented.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Retrospective Analysis to Determine the Optimal Timing to Discontinue Continuous Antibiotic Prophylaxis in Patients with Primary Vesicoureteral Reflux

et al. 2019

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“…Die Annahme, dass mit zunehmendem Alter das Risiko neuer pyelonephritischer Narben abnimmt, hat zu der inzwischen vielerorts praktizierten Strategie geführt, nach länge-ren infektionsfreien Intervallen bei Mäd-chen die antibakterielle Prophylaxe auch bei persistierendem niedriggradigem VUR versuchsweise abzusetzen [9]. Nur wenige Studien existieren, die dieses Vorgehen rechtfertigen [1,5,14]. So konnte in einer retrospektiven Untersuchung von 196 Kindern mit bekanntem VUR gezeigt werden, dass es nach Absetzen der antibakteriellen Prophylaxe etwa genauso häufig zu Parenchymnarben kam wie zuvor unter Prophylaxe [14].…”

Section: Wie Lange Sollte Beim Vesikoureteralen Reflux Eine Antibakteunclassified

Antibacterial prophylaxis in primary vesicoureteral reflux

2008

Monatsschr Kinderheilkd

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“…1 Primary vur occurs in 1-2% of the pediatric population and in 30-40% of children presenting with urinary tract infections (utis). [1][2][3][4][5] the association of vur, uti and renal parenchymal damage is well known. 6,7 renal parenchymal damage can be congenital or acquired.…”

Section: Introductionmentioning

confidence: 99%

Genetics of vesicoureteral reflux

et al. 2011

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| Primary vesicoureteral reflux (VUR) is the most common urological anomaly in children, affecting 1-2% of the pediatric population and 30-40% of children presenting with urinary tract infections (UTIs). Refluxassociated nephropathy is a major cause of childhood hypertension and chronic renal failure. The hereditary and familial nature of VUR is well recognized and several studies have reported that siblings of children with VUR have a higher incidence of reflux than the general pediatric population. Familial clustering of VUR implies that genetic factors have an important role in its pathogenesis, but no single major locus or gene for VUR has yet been identified and most researchers now acknowledge that VUR is genetically heterogeneous. Improvements in genome-scan techniques and continuously increasing knowledge of the genetic basis of VUR should help us to further understand its pathogenesis.

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The Outcome of Stopping Prophylactic Antibiotics in Older Children With Vesicoureteral Reflux

Abstract: The majority of children did well following cessation of antibiotic prophylaxis despite persistent vesicoureteral reflux. Cessation of antibiotic prophylaxis is a reasonable option in a highly select patient population with reflux.

Cited by 21 publications

References 23 publications

Retrospective Analysis to Determine the Optimal Timing to Discontinue Continuous Antibiotic Prophylaxis in Patients with Primary Vesicoureteral Reflux

Retrospective Analysis to Determine the Optimal Timing to Discontinue Continuous Antibiotic Prophylaxis in Patients with Primary Vesicoureteral Reflux

Antibacterial prophylaxis in primary vesicoureteral reflux

Genetics of vesicoureteral reflux

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