Prophylaxis in urinary tract infection in children with myelomeningocele

Area of Science:

• Pediatric Urology
• Infectious Diseases
• Nephrology

Background:

• Myelomeningocele is a complex congenital condition often associated with urinary tract dysfunction.
• Urinary tract infections (UTIs) are a common complication in children with myelomeningocele, posing risks for renal damage.
• Prophylactic antibiotic therapy is sometimes considered to manage recurrent UTIs in this population.

Purpose of the Study:

• To evaluate the efficacy of nitrofurantoin prophylaxis in reducing the incidence of urinary tract infections in infants and children diagnosed with myelomeningocele.
• To assess the emergence of antibiotic resistance and its impact on re-infection rates during nitrofurantoin prophylaxis.

Main Methods:

• A clinical trial involving 39 infants and children with myelomeningocele was conducted.
• Participants received prophylactic treatment with nitrofurantoin.
• Incidence of urinary tract infections, development of resistant bacterial strains, and re-infection rates were monitored.

Main Results:

• Nitrofurantoin prophylaxis did not result in a lower incidence of urinary tract infections compared to baseline or control groups.
• The emergence of nitrofurantoin-resistant bacterial strains was observed in a subset of the treated children.
• Children who developed resistant strains experienced a higher risk of recurrent urinary tract infections.

Conclusions:

• Prophylactic use of nitrofurantoin is not effective in preventing urinary tract infections in pediatric patients with myelomeningocele.
• The development of antibiotic resistance is a significant concern, potentially increasing the burden of recurrent infections.
• Alternative strategies for UTI prevention and management should be explored for children with myelomeningocele.