Purpose of Review Antibiotic prophylaxis is prescribed to prevent recurrent urinary tract infections (UTIs) in children, but this practice is being questioned with attention to efficacy and potential harm of long-term antibiotics. Recent Findings Prophylaxis for children with vesicoureteral reflux remains controversial and providers should consider factors that contribute to risk of recurrent UTI such as age, sex, circumcision status, reflux grade, and bladder and bowel dysfunction. Further complicating our understanding of the impact of prophylaxis is evidence that adherence is poor. Antibiotic resistance is a growing problem that is exacerbated by prophylaxis. Summary Some children have a reduced rate of recurrent UTIs when treated with prophylaxis, though which subset of those at risk who will benefit remains unclear. Given this uncertainty, current guidelines allow physicians to individualize care. Reduction of recurrent UTIs must be balanced with the harm of prophylaxis, including the development of antibiotic resistance. . . . . . Keywords Antibiotic prophylaxis Antibiotic resistance Hydronephrosis Pediatrics Urinary tract infections Vesicoureteral reflux Introduction screening or with a decrease in the number of symptomatic UTIs during treatment [1, 3]. An additional consideration was A Brief History uropathogen sensitivity to other available antimicrobial agents, which was deemed important in
Current Pediatrics Reports – Springer Journals
Published: May 28, 2018
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