کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3862480 1598895 2015 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Early Discontinuation of Antibiotic Prophylaxis in Patients with Persistent Primary Vesicoureteral Reflux Initially Detected during Infancy: Outcome Analysis and Risk Factors for Febrile Urinary Tract Infection
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری‌های کلیوی
پیش نمایش صفحه اول مقاله
Early Discontinuation of Antibiotic Prophylaxis in Patients with Persistent Primary Vesicoureteral Reflux Initially Detected during Infancy: Outcome Analysis and Risk Factors for Febrile Urinary Tract Infection
چکیده انگلیسی

PurposeWe retrospectively assessed the incidence of and risk factors for febrile urinary tract infection in children during active surveillance after early discontinuation of antibiotic prophylaxis.Materials and MethodsWe retrospectively evaluated 9 females and 61 uncircumcised males diagnosed with primary vesicoureteral reflux before age 1 year who had persistent reflux on followup voiding cystourethrogram and were subsequently followed under active surveillance without continuous antibiotic prophylaxis. Patients with secondary vesicoureteral reflux or associated urological abnormality were excluded. Clinical outcomes, including incidence of febrile urinary tract infection and new scar formation, were evaluated. Risk factors for febrile urinary tract infection were also analyzed.ResultsMean age at stopping continuous antibiotic prophylaxis was 21 months, and mean followup was 61 months. During active surveillance 21 patients had febrile urinary tract infection, and the 5-year infection-free rate under active surveillance was 67.5%. One or 2 foci of minimal new scarring developed in 4 of 16 patients who underwent followup dimercapto-succinic acid scan after febrile urinary tract infection. On multivariate analysis dilated vesicoureteral reflux on followup voiding cystourethrogram was the only significant risk factor for febrile urinary tract infection.ConclusionsThis study revealed that about two-thirds of patients with persistent vesicoureteral reflux were free of febrile urinary tract infection during 5 years of active surveillance. Those with dilated vesicoureteral reflux on followup voiding cystourethrogram are at significantly greater risk for febrile urinary tract infection. Accordingly active surveillance, especially in patients with nondilated vesicoureteral reflux on followup voiding cystourethrogram, seems to be a safe option even in children who have not yet been toilet trained.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Urology - Volume 193, Issue 2, February 2015, Pages 637–642
نویسندگان
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