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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
Pearl Toh, 03 Jan 2020
Antibiotic resistance of Helicobacter (H.) pylori has more than doubled in Europe in the past two decades, raising alarm on the gravity of the issue of growing bacterial resistance to commonly-used antibiotics, a study presented at UEG Week 2019 has shown.
02 Dec 2019
Utilizing a clinical pharmacist specialist in a hepatitis C virus (HCV) treatment clinic may help improve drug therapy management of HCV-infected patients treated with direct-acting antivirals (DAAs), suggests a recent study.
Pearl Toh, 26 Sep 2019
The Singapore Health Sciences Authority (HSA) has recalled eight brands of ranitidine products containing trace amounts of the nitrosamine impurity NDMA*, which is a potential human carcinogen.
2 days ago
The use of folic acid in addition to enalapril in the treatment of patients with hypertension yields a modest increase in lifetime stroke-free survival, a study has found.