Painful, frequent and urgent urination — they’re the telltale signs of a urinary tract infection, or UTI, something most pediatricians see on a regular basis. The approach to care is usually simple: urinalysis, a course of antibiotics, plenty of fluids and a discussion about proper hygiene. Most of the time, the infection clears up with no further issues. …Read More
When treating children with a history of urinary tract infections (UTIs) and reflux, pediatricians and primary care staff treat their young patients with preventative antibiotics. Although antimicrobial prophylaxis has been proven effective in preventing recurrent UTI in children specifically with vesicoureteral reflux, the question caregivers often ask is:
“Are you doing more harm than good in terms of creating resistance?”
According to Caleb Nelson, MD, MPH director of Quality and Safety and attending urologist in the Department of Urology at Boston Children’s Hospital, this question often causes a pause or prompts reluctance to use the medication.
“From the pediatrician standpoint, it’s useful to know more about what happens when you treat these kids in terms of how the resistance patterns change – or don’t change, over time.”
Urinary tract infections affect approximately 3 percent of children in the United States and account for more than 1 million visits to pediatricians’ offices every year.
Although antimicrobial prophylaxis has been proven effective in preventing recurrent UTI in children specifically with vesicoureteral reflux, there remains an increased antibiotic resistance in children treated with antibiotics.
A recent study titled “Antimicrobial Resistance and Urinary Tract Infection Recurrence” sought to further investigate the relationship of antibiotic use and antibiotic resistance among children with vesicoureteral reflux. The paper, published in Pediatrics by the American Academy of Pediatrics (AAP), shows that although resistance was more common among children on antibiotic prophylaxis, antibiotic resistance decreased the longer the children stayed on prophylaxis.
This surprising finding suggests that children who require extended prophylaxis may not be at as high a risk of resistant infection as commonly thought.