Urinary Tract Infections Prevention

Prophylaxis Not Associated with Lower Recurrence of UTIs in Children

Physician's First Watch for July 11, 2007

The use of antimicrobial prophylaxis after a first childhood urinary tract infection is not associated with lower rates of recurrence — and in fact is associated with an increased risk for resistant infections, according to a JAMA study.

Researchers followed some 600 children under age 6 with first episodes of UTI for over a year to examine the characteristics that would predict recurrent infections. They found that white race, age 3 to 5 years, and grade 4 to 5 vesicoureteral reflux were all factors associated with increased risk for recurrence. Antimicrobial prophylaxis had no effect on recurrence risk, but among children in whom infection recurred, prophylaxis was associated with an increased risk for resistant infections.

The authors suggest that clinicians "discuss the risks and unclear benefits of prophylaxis with families ... after a first UTI."

JAMA article (Free)