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Updated: Jun 24, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Could prophylactic antibiotics be stopped in patients with history of vesicoureteral reflux?
Laura F Alconcher1, Maria B Meneguzzi, Roberto Buschiazzo
1Department of Pediatrics, Division of Pediatric Nephrology, Hospital Interzonal General de Agudos Dr Jose Penna, Lainez 2401, Bahía Blanca, 8000 Buenos Aires, Argentina. alconcher@speedy.com.ar
Insights
Stopping prophylactic antibiotics (PA) for children with vesicoureteral reflux (VUR) is safe. The study found a lower incidence of urinary tract infections (UTIs) after discontinuing PA, suggesting it
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
Background:
- Vesicoureteral reflux (VUR) is a common cause of urinary tract infections (UTIs) in children.
- Prophylactic antibiotics (PA) are often used to prevent recurrent UTIs in patients with VUR.
Purpose of the Study:
- To compare UTI incidence and type in VUR patients on PA versus after PA discontinuation.
- To evaluate the safety and efficacy of stopping PA in VUR management.
Main Methods:
- Retrospective analysis of 77 VUR patients followed for at least 1 year after stopping PA.
- Recorded UTI episodes (cystitis vs. acute pyelonephritis), time on/off PA, and renal scan outcomes.
- Discontinuation criteria included: 12+ months UTI-free on PA, age-appropriate communication, potty training, and no risk factors.
Main Results:
- Mean age for PA start/stop: 18.5/61 months. Mean time on PA: 39 months.
- During PA: 44 UTI episodes (0.17/patient/year), 70% acute pyelonephritis (APN).
- After stopping PA: 24 UTI episodes (0.08/patient/year), 33% APN (P<0.05). Two patients lost renal function on PA.
Conclusions:
- Discontinuing PA in VUR patients is a safe management option.
- Lower UTI incidence and APN rates observed after PA cessation.
- Supports considering PA discontinuation as a viable strategy in VUR management.
Objective:
To compare the incidence and type of urinary tract infection (UTI) in patients with primary vesicoureteral reflux (VUR) diagnosed after a febrile UTI while they were on prophylactic antibiotics (PA) and after stopping PA.
Materials And Methods:
Criteria to discontinue PA were: no UTI during 12+ or more months on PA, old enough to communicate UTI symptoms, potty trained and absence of risk factors for UTI. Patients with at least 1 year of follow up without PA were included (n=77). We recorded: age at which PA was indicated and stopped, time on and off PA, incidence and type of UTI (cystitis vs acute pyelonephritis (APN)), and renal scan results.
Results:
PA was started and stopped at a mean age of 18.5 and 61 months, respectively. Mean time on PA was 39 months (range 12-95): 25 patients had 44 UTI episodes (0.17 episodes/patient/year), and 31 (70%) of them were APN. Mean time of antibiotics was 44.5 months (range 12-162): 13 patients had 24 UTI episodes (0.08 episodes/patient/year), eight (33%) of which were APN (P<0.05). A renal scan was performed in 71 patients after the index infection and repeated in 12. Two patients lost renal function while still on PA.
Conclusion:
Discontinuing PA in patients with history of VUR is a safe practice and should be considered as a management option.
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