Long-term follow-up of children with vesicoureteral reflux with and without antibiotic prophylaxis

• Published in: Scandinavian journal of infectious diseases Vol. 37; no. 11-12; pp. 842 - 845
• Main Authors: Georgaki-Angelaki, H, Kostaridou, S, Daikos, G. L, Kapoyiannis, A, Veletzas, Z, Michos, A. G, Syriopoulou, V. P
• Format: Journal Article
• Language: English
• Published: Basingstoke Informa UK Ltd 2005; Taylor & Francis
• Subjects: Anti-Bacterial Agents - administration & dosage; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Child; Child, Preschool; Female; Follow-Up Studies; Greece; Humans; Infant; Infectious diseases; Kidney - pathology; Male; Medical sciences; Nephrology. Urinary tract diseases; Pharmacology. Drug treatments; Safety; Time Factors; Urinary system involvement in other diseases. Miscellaneous; Urinary Tract Infections - etiology; Urinary Tract Infections - pathology; Urinary Tract Infections - prevention & control; Urinary tract. Prostate gland; Vesico-Ureteral Reflux - complications; Vesico-Ureteral Reflux - drug therapy; Vesico-Ureteral Reflux - pathology; Greece; Human; Prevention; Infection; Chemoprophylaxis; Urinary system disease; Microbiology; Vesicoureteral reflux; Bladder disease; Urinary tract disease; Antibacterial agent; Child; Long term
• ISSN: 0036-5548; 1651-1980
• DOI: 10.1080/00365540500279918

The aim of the present study was to obtain data on the outcome of children with persistent vesicoureteral reflux (VUR) after cessation of antibiotic prophylaxis. Children with VUR who had been on antibiotic prophylaxis for at least 2 y and were free of urinary tract infections (UTI), had normal voiding patterns, and no hydronephrosis or new kidney scarring, had antibiotic prophylaxis discontinued, were followed up prospectively with urine cultures, voiding cystourethrography, and technecium-99m dimercaptosuccinate renal scintigraphy. The findings were compared with those of the same patients while they were on antibiotic prophylaxis. In 54 children (39 girls and 15 boys), antibiotic prophylaxis was discontinued. The mean follow-up time on and off antibiotic prophylaxis was 4.4±2.1 and 4.4±2.2 y, respectively. Nine UTI episodes occurred during the on- and 8 during the off-prophylaxis period. In 80 of 96 and in 68 of 74 ureters the reflux resolved or downgraded during the on- and off-prophylaxis periods, respectively. No new scar lesions were detected in any of the children. In conclusion, in children with persistent VUR and certain characteristics, antibiotic prophylaxis can be safely discontinued.