There is likely value in offering antibiotic prophylaxis to decrease urinary tract infection risk in infants with high-grade hydronephrosis, but data on the subject remain limited, according to research published online this month.
Luis H. Braga, MD, PhD, McMaster University, Hamilton, Ontario, Canada, and colleagues at the Hospital for Sick Children, Toronto, conducted an analysis of 1,681 articles in four electronic databases published between 1990 and 2010.
Luis H. Braga
The researchers said, in children with higher-grade hydronephrosis, patients who received antibiotic prophylaxis had a significantly lower UTI rate compared with those who did not receive antibiotics, and the number needed to treat to prevent one infection was seven.
This research follows research published earlier this year at the AAP National Conference and Exhibition, where Braga and colleagues said female gender, not being circumcised and not receiving treatment with antibiotics were all associated with a higher rate of febrile UTIs. The protective effects of circumcision and antibiotics were more evident in high-grade hydronephrosis, the researchers noted in that study.
Braga and colleagues said their most recent paper did not permit them to study other factors such as gender, reflux and circumcision status, due to the study’s review nature.
“Current lack of best practice guidelines in the pediatric urology community, coupled with the controversial literature surrounding this topic, calls for prospective, randomized placebo-controlled trials to investigate the effect of [continuous antibiotic prophylaxis] in reducing UTI rates in infants with antenatal hydronephrosis,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.
Luis H. Braga, MD, PhD,can be reached at 1200 Main Street West, HSC Room 4E19, Hamilton, ON L8N3Z5 Canada; email: firstname.lastname@example.org.