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29 Jul 2020
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Rachel Soon, 24 Apr 2018

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Antibiotic prophylaxis helps prevent recurrent UTI-related new renal scarring

05 Aug 2019
The increasing shortage of a commonly used antibiotic, Tazocin, has raised concerns on an international scale.

Antibiotic prophylaxis can reduce the risk of new renal scarring associated with recurrent urinary tract infection (UTI), results of the RIVUR* trial have shown.

The authors included 489 patients (mean age, 20.3 months; 91 percent female). Those with recurrent UTI were more likely to have any new renal scarring (odds ratio [OR], 4.1, 95 percent CI, 2.0–8.5; p<0.01) after adjusting for age, sex, index UTI, duplication, bowel bladder dysfunction and antibiotic prophylaxis.

Fewer patients on antibiotic prophylaxis (n=5/244; 2 percent) than on placebo (n=13/245; 5 percent) experienced recurrent UTI-related new renal scarring.

Children on placebo had a higher risk of recurrent UTI-related new renal scarring (OR, 3.1, 1.0–8.8; p=0.04) compared with those on antibiotic prophylaxis after further adjustments for hydronephrosis, vesicoureteral reflux grade and baseline renal scarring.

No between-group differences were observed in scar severity at final dimercaptosuccinic acid scan (p=0.88) or change from baseline (p=0.53).

“It remains unclear why new renal scarring developed in a proportion of [patients] without recurrent urinary tract infection,” the authors said. “The results should be carefully interpreted due to the inherent limitations.”

This study included children with dimercaptosuccinic acid scan within 6 months of enrolment and at least 1 follow-up dimercaptosuccinic acid scan from the RIVUR trial. Recurrent UTI-related new renal scarring, defined as recurrent UTI and new changes on dimercaptosuccinic acid scan, was the primary outcome. Propensity score was used to adjust for confounders due to a low number of events. The associations between covariates and outcome was assessed using multivariate logistic regression.

*Randomized Intervention for Children with Vesicoureteral Reflux

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Most Read Articles
29 Jul 2020
Adjunctive perampanel appears to be safe and effective for long-term treatment of patients with tonic‐clonic seizures, according to a posthoc analysis.
27 Apr 2020
Long-term use of brivaracetam as an adjunctive treatment is well tolerated and effective in patients with focal seizures or primary generalized seizures, as shown in a study.
01 Apr 2019
Perampanel is safe and effective for treating refractory focal seizures in both Asian and non‐Asian populations, a study has found.
Rachel Soon, 24 Apr 2018

MIMS Pharmacist presents an overview of CoQ10's physiological role, as well as contemporary research on its pharmacology and effects.