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Trimethoprim-sulphadiazine prophylaxis in children with vesico-ureteric reflux
Insights
Long-term low-dose co-trimazine effectively prevented urinary tract infections in children with dilated vesico-ureteric reflux. This prophylaxis was particularly successful in boys, with no breakthrough infections observed.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Pharmacology
Background:
- Urinary tract infections (UTIs) are common in children with vesico-ureteric reflux (VUR).
- Recurrent UTIs can lead to renal scarring and long-term kidney damage.
- Prophylaxis is often used to prevent UTIs in high-risk pediatric populations.
Purpose of the Study:
- To evaluate the efficacy of long-term, low-dose co-trimazine prophylaxis.
- To assess the rate of breakthrough urinary tract infections in children with dilated VUR.
Main Methods:
- A study involving 55 children diagnosed with dilated vesico-ureteric reflux.
- Administration of low-dose co-trimazine (1-2 mg trimethoprim and 4.5-9 mg sulphadiazine per kg body weight) for long-term prophylaxis.
- Monitoring for breakthrough urinary tract infections and recording recurrence rates.
Main Results:
- In 44 girls, 13 experienced breakthrough UTIs, predominantly caused by resistant bacteria and of pyelonephritic type.
- The UTI recurrence rate in girls was 1.5 per 100 treatment months.
- In 11 boys, no breakthrough infections occurred over 311 treatment months.
Conclusions:
- Long-term, low-dose co-trimazine is an effective preventative strategy for UTIs in children with dilated VUR.
- The drug demonstrated significant efficacy in preventing infections in this high-risk pediatric group.
- Boys with VUR showed a particularly favorable response to co-trimazine prophylaxis.
Abstract:
The efficacy of long-term low-dose prophylaxis with co-trimazine (1-2 mg trimethoprim and 4.5-9 mg sulphadiazine per kg body weight) was studied in 55 children with dilated vesico-ureteric reflux. Of 44 girls, there were 13 with break-through urinary tract infection, all caused by resistant bacteria and in all but one case of pyelonephritic type. The recurrence rate was 1.5/100 treatment months. In 11 boys, there were no break-through infections in 311 treatment months. Co-trimazine was thus an effective drug for prevention of urinary tract infection in this high-risk population.