Re: Observation of patients with vesicoureteral reflux off antibiotic prophylaxis: Physician bias on patient selection and risk factors for recurrent febrile urinary tract infection

摘要

Because it has been suggested that some children with vesi-coureteral reflux (VUR) can be managed without prophylactic antibiotics, the authors report 224 children that they followed without continuous antibiotic prophylaxis (CAP) for a median of 2.2 yr (range: 0-8.8 yr). These children tended to be older than the authors' patients treated with CAP. Of the children observed without CAP, 8.5% developed a febrile urinary tract infection at a median time of 8 mo. Of 305 patients with CAP followed for 1.2 yr (range: 0-8.4 yr), 19.5% developed a febrile urinary infection at a median time of 12 mo. There was a higher prevalence of bowel and bladder dysfunction in the children who were maintained on CAP. The patients observed without CAP were less likely to have had afebrile urinary infections at initial presentation and lower grades of reflux and were older at initial presentation.