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Value of preventive antibiotics to treat UTIs in children questioned
Value of preventive antibiotics to treat UTIs in children questioned

July 10, 2007 (Insidermedicine) Preventive antibiotics do not reduce the risk of recurrent urinary tract infections in children but do increase the risk of antibiotic-resistant infections, according to a report published in the Journal of the American Medical Association. 

It is estimated that 3% of children in the US will experience a urinary tract infection – or UTI - by age six. A UTI is a bacterial infection of the organs and tubes that make up the urinary tract. UTIs in children usually clear up quickly if they receive early treatment with antibiotics. The biggest concern about untreated UTIs in children is that they can cause permanent kidney damage and scarring. While the symptoms of UTIs can often go unnoticed in children, they can include an unexplained fever, urine with an unusual smell, a lack of appetite, vomiting, and irritability.  

In children with a repeat UTI, an imaging study to evaluate for the presence and degree of backflow of urine from the bladder into the ureter is recommended. The ureters are the tubes that connect each kidney to the bladder. This backflow occurs in approximately 30 to 40% of children with a UTI. If the child has this condition, daily antibiotic treatment is recommended in an attempt to prevent recurrent UTIs. There is limited evidence, however, regarding the risks and benefits of antibiotic treatment. 

In the present study, researchers assessed close to 75,000 children who had experienced a UTI before age six. 

They found that young white children were at the greatest risk for recurrent infections and that exposure to antibiotics had no effect on the risk of recurrent infections. Exposure to preventive antibiotics raised the risk of experiencing antibiotic-resistant infections by seven-fold. 

Based on the findings, it is prudent for doctors to discuss the risks and benefits of preventive antibiotic treatment with families. This will help families make an informed decision regarding their treatment options.

Reporting for Insidermedicine, I’m Dr. Susan Sharma.