Antibiotics Won't Prevent Urinary Tract Infections in Kids: Study

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Gender, less severe VUR and exposure to other antibiotics were not associated with a risk of recurrence.

Preventive antimicrobial therapy did not lower a child's risk of recurrent UTI, the researchers found. However, prior use of antibiotics to prevent infection did boost the likelihood of developing a drug-resistant infection by nearly 7.5 times. Indeed, 61 percent of recurrent urinary tract infections were caused by a pathogen with antibiotic resistance, the researchers pointed out.

Although non-white children were less likely than Caucasian children to have recurrent infections, they ran a greater risk of developing an antibiotic-resistant recurrent infection, the researchers found.

Based on these findings, kids who suffer from recurrent UTIs will likely be treated "as the infections come up," Wheeler said.

According to the authors, this study is the first to look at the effectiveness of preventive antibiotics in a large primary care pediatric population and the first to determine risk factors in such a group.

"For individual physicians and patients, we would suggest that they consider discussing the unclear benefits and risks of daily antibiotics to prevent UTIs and let families decide whether to give daily antibiotics or just monitor for symptoms," said study lead author Dr. Patrick H. Conway, an assistant professor of pediatrics at Cincinnati Children's Hospital, who was a Robert Wood Johnson clinical scholar at the University of Pennsylvania at the time the study was done.

"We hope that the American Academy of Pediatrics will consider this large study in a pediatric care population in potentially revising their guidelines," Conway said. "We think it's reasonable to not follow the guidelines and explain to parents the potential risks and benefits of prophylaxis and [possibly] not start daily antibiotics."

"It was an impressive increased risk of resistance, 7.5 times if exposed to daily antibiotics," Conway noted.

More information

Visit the National Kidney and Urologic Diseases Information Clearinghouse for more information on urinary tract infections.