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02 Apr 2019
Using preventive zinc and micronutrient powder supplementation does not appear to improve growth in children, a recent study has found.
Pearl Toh, 01 May 2019
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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]

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Most Read Articles
Joyce Lam Ching Mei, 28 Mar 2019
April 17 marks World Haemophilia Day, and this year’s theme is  “Reaching Out – The First Step to Care”. Adjunct Assoc Prof Joyce Lam Ching Mei, head of the Haematology Laboratory and Blood Bank and senior consultant from the Paediatric Haematology/Oncology Service at KK Women’s and Children’s Hospital, Singapore, speaks to Elaine Soliven on the importance of recognizing and managing bleeding disorders in primary care.
02 Apr 2019
Using preventive zinc and micronutrient powder supplementation does not appear to improve growth in children, a recent study has found.
Pearl Toh, 01 May 2019
Preterm infants with very low birth weight (VLBW) who were breastfed have significantly higher levels of metabolites important for brain growth and development in their brain tissue compared with formula-fed infants, suggesting that breastfed infants have improved cerebral metabolism at term-equivalent age, according to a study presented at the PAS 2019 Meeting.