Louis M. Bell, MD reviewing Hewitt IK et al. Pediatrics 2017 Apr 6.

Meta-analysis findings support current recommendations against prophylactic antibiotic use for first pediatric febrile UTI.

Long-term antibiotic prophylaxis has been used in children with febrile urinary tract infection (UTI) in an attempt to reduce the risk for recurrent UTI and associated renal scarring.

To determine the efficacy of this treatment approach for preventing renal scarring, investigators conducted a systematic review and meta-analysis, identifying seven randomized, controlled trials and analyzing data on 1427 children aged <18 years.

Overall, antibiotic prophylaxis did not prevent renal scarring. In a subanalysis of 1076 children with documented vesicoureteral reflux, and therefore at higher risk for scarring, prophylaxis did not prevent renal scarring. The risk for developing new scarring was approximately 6% in this cohort of children, which predominantly comprised girls.

CITATION(S):

Hewitt IK et al. Antibiotic prophylaxis for urinary tract infection–related renal scarring: A systematic review. Pediatrics 2017 Apr 6; [e-pub].

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