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Antibiotics for performing voiding cystourethrogram: a randomised control trial.
- Source :
- Archives of Disease in Childhood; Mar2018, Vol. 103 Issue 3, p230-234, 5p, 1 Diagram, 3 Charts
- Publication Year :
- 2018
-
Abstract
- <bold>Objective: </bold>To assess whether antibiotic reduces voiding cystourethrogram (VCUG)-associated urinary tract infection (UTI).<bold>Design: </bold>Open-labelled randomised controlled trial.<bold>Setting: </bold>Tertiary paediatric nephrology centre.<bold>Patients: </bold>120 children (age 2 months-5 years) undergoing VCUG.<bold>Interventions: </bold>Children were randomised into group A (antibiotic, n=72) or group B (no antibiotic, n=48) in 3:2 ratio. Group A received oral antibiotic (cephalexin if <6 months or co-trimoxazole if >6 months old) a day prior to VCUG and continued for 1 day post VCUG.<bold>Main Outcome Measures: </bold>The main outcome measure is incidence of VCUG-associated UTI. Urine was checked on day 3 after VCUG and UTI was defined as significant growth of a single organism in a symptomatic child.<bold>Results: </bold>The median age was 8 months (IQR 13 months) with 68% male. Indication for undertaking VCUG was history of UTI (first UTI in infancy=43, recurrent UTI=49) and congenital anomaly of kidney and urinary tract without any UTI (n=28). Post-VCUG UTI was significantly higher among group B in comparison to group A (17% (n=8) vs 1.4% (n=1); p=0.01, OR=14.2 (95% CI 1.7 to 117)). Multivariate binary logistic regression analysis found an abnormal pre-VCUG ultrasound scan to be a significant independent risk factor for post-VCUG UTI (p=0.02, OR=9.51, 95% CI 1.43 to 63.4). The number needed to treat with antibiotic to prevent one post-VCUG UTI was 6.5, which reduced to 4 if only the group with abnormal pre-VCUG ultrasound scan was included.<bold>Conclusions: </bold>Antibiotic significantly reduces post-VCUG-acquired UTI especially in those with abnormal ultrasound scans.<bold>Trial Registration Number: </bold>Clinical Trial Registry of India: CTRI/2017/03/00824. [ABSTRACT FROM AUTHOR]
- Subjects :
- URINARY tract infections in children
ANTIBIOTICS
URETHROGRAPHY
KIDNEY abnormalities
VESICO-ureteral reflux
THERAPEUTICS
URINARY tract infection prevention
CEPHRADINE
COMPARATIVE studies
GENITOURINARY organ abnormalities
GENITOURINARY organ radiography
RESEARCH methodology
MEDICAL cooperation
RESEARCH
URINARY tract infections
URINATION
EVALUATION research
RANDOMIZED controlled trials
TREATMENT effectiveness
DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 00039888
- Volume :
- 103
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- Archives of Disease in Childhood
- Publication Type :
- Academic Journal
- Accession number :
- 128141389
- Full Text :
- https://doi.org/10.1136/archdischild-2017-313266