Antibiotic prophylaxis cuts UTIs in congenital hydronephrosis

(HealthDay)—Continuous antibiotic prophylaxis (CAP) reduces the risk of febrile urinary tract infection (UTI) in children with asymptomatic antenatal hydronephrosis (ANH), according to a study published online July 22 in the Journal of Pediatric Urology.

Daniel Herz, M.D., from Nationwide Children's Hospital in Columbus, Ohio, and colleagues examined electronic medical records from children referred for congenital ANH (2001 through 2011) with at least 24 months of follow-up. Children were characterized as those maintained on CAP (YCAP; 278 patients) and those not maintained on CAP (NCAP; 127 patients).

The researchers found that, overall, the incidence of febrile UTI during the follow-up period was 22.2 percent. The incidence of febrile UTI was significantly higher with NCAP (18.7 percent, compared to 7.9 percent in YCAP; P = 0.021). Independent risk factors for febrile UTI included ureteral dilation, high-grade vesicoureteral reflux, and ureterovesical junction obstruction. For children with ureteral dilation >11 mm not maintained on CAP, there was a 5.54-fold increased risk of febrile UTI when compared to those maintained on CAP (P = 0.001).

"Therefore CAP may have a significant role in reducing the risk of febrile UTI in children with ANH with those identifiable risk factors, but otherwise seems unnecessary," the authors write.

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