Selective Antimicrobial Prophylaxis for Vesicoureteral Reflux

The use of continuous antibiotic prophylaxis in the prevention of urinary tract infection (UTI), particularly in children with vesicoureteral reflux, has been studied extensively during the past 15 years. Double-blind, placebo-controlled trials such as the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial and the Prevention of Recurrent Urinary Tract Infection in Children with Vesicoureteric Reflux and Normal Renal Tracts (PRIVENT) trial showed that continuous antibiotic prophylaxis significantly reduced the risk of UTI among children with vesicoureteral reflux.(1,2) However, other randomized trials showed either no beneficial effect(3-7) or a beneficial effect that was limited to female patients.(8) These variations . . .