Efficacy of Probiotic Prophylaxis After The First Febrile Urinary Tract Infection in Children With Normal Urinary...

Area of Science:

• Pediatrics
• Microbiology
• Infectious Diseases

Background:

• Antibiotic resistance necessitates alternative strategies for preventing recurrent urinary tract infections (UTIs).
• Efficacy of antibiotic prophylaxis for pediatric UTIs is debated, prompting research into nonantibiotic options.

Purpose of the Study:

• To evaluate the efficacy of a probiotic mixture in preventing recurrent UTIs in children.
• To compare probiotic prophylaxis against placebo in children with a history of febrile UTI.

Main Methods:

• 181 children (4 months–5 years) with a normal urinary tract were randomized to receive probiotics or placebo for 18 months.
• The primary endpoint was composite cure (UTI-free survival) at 18 months.
• Secondary endpoint included median time to first UTI recurrence.

Main Results:

• Probiotic group showed significantly higher composite cure rates (96.7%) versus placebo (83.3%) at 18 months (P = .02).
• Median time to first UTI recurrence was shorter in the probiotic group (3.5 months) compared to placebo (6.5 months) (P = .04).
• No significant adverse events were reported with probiotic use.

Conclusions:

• Probiotic administration was more effective than placebo in reducing the risk of recurrent UTIs in children.
• Probiotics represent a promising nonantibiotic prophylactic strategy for pediatric recurrent UTIs.