Most Read Articles
Kavitha G. Shekar, 19 Aug 2015
Haematologic disorder, increasing age, malar rash, and autoantibodies are early predictors of arthritis in paediatric patients with systemic lupus erythematosus (SLE), a longitudinal cohort study has shown.
01 Dec 2017
Bifidobacteria supplementation to infant diet helps curb the occurrence of specific bacteria and metabolites during early life, a recent study has shown, adding that no long-term effects have been detected.

Antibiotic helps prevent voiding cystourethrogram-acquired UTI in children

25 Sep 2017

Treatment with antibiotic results in significant reduction in voiding cystourethrogram (VCUG)-associated urinary tract infection (UTI), especially in children with abnormal ultrasound scans, a study has found.

In an open-label trial, 120 children who were aged 2 months to 5 years and undergoing VCUG were randomly assigned to the group treated with antibiotic (n=72; median age 10 months; 68 percent male) or to the group that did not receive treatment (n=48; median age 7 months; 71 percent male). The antibiotic group received cephalexin if <6 months or cotrimoxazole if >6 months old a day prior to VCUG and continued for 1 day after the procedure.

The primary endpoint was incidence of VCUG-associated UTI. Urine was evaluated on day 3 after VCUG, and UTI was defined as significant growth of a single organism in a symptomatic child.

In the cohort, the most common indications for VCUG were history of UTI (43 children had first UTI in infancy; 49 had recurrent UTI) and congenital anomaly of kidney and urinary tract without any UTI (n=28).

Compared with the antibiotic group, the no-treatment group had a significantly higher proportion of children who developed post-VCUG UTI (17 vs 1.4 percent; p=0.01; odds ratio [OR], 14.2; 95 percent CI, 1.7 to 117).

On multivariate binary logistic regression analysis, an abnormal pre-VCUG ultrasound scan emerged as a significant independent risk factor for post-VCUG UTI (p=0.02; OR, 9.51; 1.43 to 63.4).

The number needed to treat with antibiotic to prevent one episode of post-VCUG UTI was 6.5, which dropped to 4 if antibiotic was restricted to children with abnormal pre-VCUG ultrasound scan.

One of the most common fluoroscopic investigations performed in paediatric radiology (up to 40 percent of all fluoroscopic-guided procedures in some centres), VCUG remains the gold standard for identifying vesicoureteric reflux and demonstrating urethral anatomy. Among the known complications of the procedure, VCUG-acquired UTI is considered an important concern as the condition has been associated with urosepsis and even death. [Pediatr Radiol 2001;1:238–46]

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS JPOG - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Kavitha G. Shekar, 19 Aug 2015
Haematologic disorder, increasing age, malar rash, and autoantibodies are early predictors of arthritis in paediatric patients with systemic lupus erythematosus (SLE), a longitudinal cohort study has shown.
01 Dec 2017
Bifidobacteria supplementation to infant diet helps curb the occurrence of specific bacteria and metabolites during early life, a recent study has shown, adding that no long-term effects have been detected.