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Prevention of recurrent urinary tract infection in children

Williams, Gabriellea,b; Craig, Jonathan Ca,b

Current Opinion in Infectious Diseases: February 2009 - Volume 22 - Issue 1 - p 72–76
doi: 10.1097/QCO.0b013e328320a885
Sexually transmitted diseases and urinary tract infections: Edited by Anton L. Pozniak
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Purpose of review Urinary tract infection (UTI) in children is common (5–10%) and recurs in 10–30%. UTI causes an unpleasant, usually febrile illness in children. This review focuses on studies evaluating interventions to prevent UTI in children and published between January 2007 and June 2008.

Recent findings Three relevant updated Cochrane reviews, six randomized trials and an evidence-based guideline were published in the study period. Five of the six trials and one of the three Cochrane updates included data on the effects of relevant interventions in children. Three of the six trials investigated the efficacy of long-term, low-dose antibiotics as prophylaxis, and the other trials and both Cochrane updates evaluated complementary therapies such as vitamin A, probiotics and herbal supplements.

Summary The benefit of prophylactic antibiotics for the prevention of recurrent UTI in children remains unclear because of underpowered and suboptimally designed trials, but these studies suggest that any benefit is likely to be small, and clinical significance may be limited. The trials of complementary interventions (vitamin A, probiotics, cranberry, nasturtium and horseradish) generally gave favourable results but were not conclusive. Children and families who use these products should be aware that further infections are possible despite their use.

aCentre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia

bScreening and Test Evaluation Program, School of Public Health, University of Sydney, Sydney, New South Wales, Australia

Correspondence to Gabrielle Williams, Centre for Kidney Research, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia Tel: +61 2 9845 1492; fax: +61 2 9845 1491; e-mail: gabriew4@cw.edu.au

© 2009 Lippincott Williams & Wilkins, Inc.