Related Experiment Video
Updated: Jun 27, 2026
An In Vitro Bladder Model of Catheter-Associated Urinary Tract Infection
Published on: June 24, 2025
Antibiotic prophylaxis for childhood urinary tract infection: a national survey
Isabelle Chevalier1, Geneviève Benoît, Marie Gauthier
1Department of Pediatrics, CHU Sainte-Justine, Montreal, Quebec, Canada. isabelle.chevalier.hsj@ssss.gouv.qc.ca
Insights
Canadian pediatricians and nephrologists show varied opinions on antibiotic prophylaxis for childhood urinary tract infections (UTI). This likely stems from a lack of strong evidence guiding their practice for UTI management.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Clinical Practice Guidelines
Background:
- Antibiotic prophylaxis for urinary tract infections (UTI) in children is a common practice, yet evidence supporting its efficacy and optimal use remains limited.
- Variations in clinical practice suggest a need to understand physician attitudes and the factors influencing prescribing habits for pediatric UTI.
Purpose of the Study:
- To describe the attitudes of Canadian pediatricians and pediatric nephrologists concerning antibiotic prophylaxis for childhood UTI.
- To identify factors associated with the use of antibiotic prophylaxis in pediatric UTI cases.
Main Methods:
- A self-administered questionnaire was distributed to 1136 Canadian pediatricians and 42 pediatric nephrologists.
- The study analyzed responses from 436 physicians who had made decisions regarding antibiotic prophylaxis for childhood UTI in the preceding year.
Main Results:
- A high percentage of physicians prescribed prophylaxis for children with all grades of vesicoureteral reflux (VUR), ranging from 69.8% for grade I to 98% for grade V.
- Prescribing practices for lower-grade VUR and for infants/children with UTI without VUR varied, with only a small proportion of physicians feeling their practice was evidence-based.
- Factors influencing prophylaxis decisions included frequency of decision-making, city size, province, frequency of pyelonephritis, and presence of voiding dysfunction.
Conclusions:
- There is considerable variation in the opinions and practices of Canadian pediatricians and nephrologists regarding antibiotic prophylaxis for pediatric UTI.
- The wide divergence in approaches is likely attributable to the limited robust evidence available to guide clinical decision-making in this area.
Aims:
To describe attitudes of paediatricians and paediatric nephrologists regarding antibiotic prophylaxis for urinary tract infection (UTI) and determine the factors associated with its use.
Method:
A self-administered questionnaire was mailed to Canadian paediatricians (1136) and paediatric nephrologists (42).
Results:
The response rate was 58.1% (684 physicians); 436 who had made a decision about antibiotic prophylaxis for childhood UTI in the previous year were included in the analysis. Of these, 407 (93.3%) were certified in paediatrics and 29 (6.7%) were paediatric nephrologists. Most respondents prescribed prophylaxis for children with grade III-V vesicoureteral reflux (VUR) (96.5%-98%); 69.8 and 92.8% prescribed it for children with grades I and II VUR, respectively. Factors significantly associated with use of prophylaxis for children with grade I VUR were frequency of decision-making about prophylaxis, city size and province. Fifteen percent of physicians felt that their practice regarding antibiotic prophylaxis for children with VUR was evidence based. A hundred one respondents (24.3%) prescribed prophylaxis for infants with a first febrile UTI in the absence of VUR. Nineteen percent felt that their practice regarding antibiotic prophylaxis for these infants was evidence based. Prescription of prophylaxis for children >12 months with recurrent UTI in the absence of VUR was influenced by frequency of pyelonephritis (88.5% of respondents) and presence of voiding dysfunction (53.8%). Nine percent of physicians felt that their practice for these children was evidence based.
Conclusion:
Opinions of Canadian paediatricians and paediatric nephrologists regarding antibiotic prophylaxis for UTI in children vary widely, probably because of the paucity of solid evidence about prophylaxis.
Related Concept Videos
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:17Urinary Tract Infection IV: Nursing Management
01:26Urine Studies II: Urine Culture and Sensitivity Test
01:26Urinary Tract Infection I: Introduction
01:25Urinary Tract Infection II: Pathophysiology
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion