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Girls and renal scarring as risk factors for febrile urinary tract infection after stopping antibiotic prophylaxis in children with vesicoureteral reflux
- Source :
- World Journal of Urology. 39:2587-2595
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- Purpose To clarify the incidence of and risk factors for febrile urinary tract infection in children with persistent vesicoureteral reflux (VUR) after the discontinuation of continuous antibiotic prophylaxis (CAP), retrospective chart review was performed. Patients and methods Among children with primary VUR at 10 years of age or younger at presentation, those who had persistent VUR despite conservative management with CAP and who were subsequently followed after discontinuation of CAP were included. Kaplan-Meier curve and Cox's proportional hazard regression model were used for evaluation of the incidence of and risk factors for febrile urinary tract infection (fUTI) after stopping CAP. Results Among 144 children (99 boys and 45 girls), fUTI developed in 34. The 5-year fUTI-free rate after discontinuation of CAP was 69.4%. On multivariate analyses, girls (p = 0.008) and abnormalities on nuclear renal scans (p = 0.0019), especially focal defect (p = 0.0471), were significant factors for fUTI. Although the fUTI-free rate was not different between children who had no or 1 risk factor, it was significantly lower in children with 2 risk factors than in those with no or 1 risk factor. Conclusions The present study revealed that girls and abnormal renal scan, especially focal defect, are risk factors for fUTI. Active surveillance without CAP for persistent VUR seems to be a safe option for children with no or 1 risk factor. Prophylactic surgery or careful conservative follow-up may be an option for girls with abnormal renal scan results if VUR persists under CAP.
- Subjects :
- Male
Nephrology
medicine.medical_specialty
Pediatrics
Multivariate analysis
Fever
Urology
030232 urology & nephrology
Vesicoureteral reflux
Cicatrix
03 medical and health sciences
Sex Factors
0302 clinical medicine
Febrile urinary tract infection
Risk Factors
Internal medicine
medicine
Humans
Antibiotic prophylaxis
Risk factor
Retrospective Studies
Vesico-Ureteral Reflux
business.industry
Incidence
Incidence (epidemiology)
Continuous antibiotic prophylaxis
Infant
Antibiotic Prophylaxis
medicine.disease
Prophylactic Surgery
Discontinuation
Withholding Treatment
Child, Preschool
030220 oncology & carcinogenesis
Urinary Tract Infections
Female
Kidney Diseases
business
Subjects
Details
- ISSN :
- 14338726 and 07244983
- Volume :
- 39
- Database :
- OpenAIRE
- Journal :
- World Journal of Urology
- Accession number :
- edsair.doi.dedup.....0c812ddb743e3a8cc9c5814dd6d6271f