Patients with urinary tract dilatation at low risk of incident UTI

19 Sep 2019
Patients with urinary tract dilatation at low risk of incident UTI

Urinary tract infection (UTI) appears to occur infrequently in patients with urinary tract dilatation (UTD), suggesting that routine continuous antibiotic prophylaxis may be avoided in this population, a study has found.

Researchers looked at 428 children (71.4 percent boys) with a prenatally diagnosed UTD, among whom 278 had a UTD confirmed after birth. According to the relevant classification system stratify risk, 126 children had low-risk UTD (UTD-P1), 95 had intermediate risk (UTD-P2) and 57 had high risk (UTD-P3).

All children with confirmed UTD underwent ultrasound (US) follow-up at 6, 12 and 24 months of life. Only 19 children (6.83 percent) were diagnosed with a UTI during follow-up.

Voiding cystourethrogram was performed in all patients who presented a UTI and in those with UTD-P3. Results revealed 11 children to have vesicoureteral reflux, and four were diagnosed with obstructive uropathy and subsequently underwent surgical correction. Five patients presented with a UTI reinfection.

None of the patients received continuous antibiotic prophylaxis.

The researchers pointed out that the occurrence of UTI in patients with UTD in the absence of continuous antibiotic prophylaxis is low, with the risk of UTI recurrence even lower.

Although further randomized trials with a longer follow-up and a cost-effective analysis are needed to confirm these results, the study provides evidence that routine prophylaxis treatment could be safely omitted in children with UTD, the researchers added.

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