Antenatal hydronephrosis (HN) is a common congenital anomaly, occurring in 1% to 5% of all pregnancies. Continuous antibiotic prophylaxis (CAP) has been recommended for newborns with HN to reduce the rate of urinary tract infections (UTIs) during the first 2 years of life. With increasing concerns about bacterial antibiotic resistance and unknown long-term effects, the use of CAP in preventing UTIs is being challenged. This systematic review was undertaken to evaluate the impact of CAP on UTI rates in infants with antenatal HN. MEDLINE, EMBASE, CINAHL, and CENTRAL databases were searched for studies that met eligibility criteria: primary diagnosis of antenatal HN; all subjects were aged younger than 2 years; interventions included CAP, no treatment, or both; reported rate of UTI and number of patients who had voiding cystourethrography; HN graded according to the Society for Fetal Urology classification or anteroposterior diameter of the renal pelvis; and published between 1990 and 2010.
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