Probiotics prophylaxis in children with persistent primary vesicoureteral reflux

Area of Science:

• Pediatric Nephrology
• Microbiology
• Infectious Diseases

Background:

• Probiotics are known for preventing gastrointestinal infections, but their efficacy in preventing urinary tract infections (UTIs) remains uncertain.
• Vesicoureteral reflux (VUR) is a condition that increases the risk of recurrent UTIs in children.
• Conventional antibiotic prophylaxis is often used for children with persistent primary VUR.

Purpose of the Study:

• To compare the preventive efficacy of probiotics versus conventional antibiotics in children experiencing persistent primary VUR.
• To evaluate the incidence of recurrent UTIs and the development of new renal scars in both treatment groups.

Main Methods:

• A prospective randomized controlled study involving 120 children with persistent primary VUR.
• Participants were allocated to receive either probiotics (Lactobacillus acidophilus) or antibiotics (trimethoprim/sulfamethoxazole) for a second year of follow-up.
• Recurrent UTI incidence, causative organisms, and new renal scar development were assessed.

Main Results:

• The incidence of recurrent UTIs was 18.3% in the probiotics group and 21.6% in the antibiotic group, with no significant difference (P = 0.926).
• No significant differences were observed in causative organisms or the development of new renal scars between the groups.
• Stratification by VUR grade, age, gender, and other factors did not reveal significant differences in UTI recurrence.

Conclusions:

• Probiotics prophylaxis demonstrated comparable effectiveness to antibiotic prophylaxis in preventing recurrent UTIs in children with persistent primary VUR.
• Probiotics represent a potentially effective alternative to antibiotics for managing recurrent UTIs in this pediatric cohort.
• Further research may explore long-term outcomes and optimal probiotic strains for UTI prevention.