Antibiotic Prophylaxis for Children with Primary Vesicoureteral Reflux Where Do We Stand Today英文文献资料.docVIP

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Antibiotic Prophylaxis for Children with Primary Vesicoureteral Reflux Where Do We Stand Today英文文献资料.doc

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Antibiotic Prophylaxis for Children with Primary Vesicoureteral Reflux Where Do We Stand Today英文文献资料

HindawiPublishingCorporation AdvancesinUrology Volume2008,ArticleID217805,5pages doi:10.1155/2008/217805 ReviewArticle AntibioticProphylaxisforChildrenwithPrimary VesicoureteralRe?ux:WhereDoWeStandToday? MichielCosters,1RitaVanDamme-Lombaerts,2ElenaLevtchenko,3andGuyBogaert4 1 2 AntibioticManagementTeam,UniversityHospitalLeuvenGasthuisberg,Herestraat49,3000Leuven,Belgium DepartmentofPediatricNephrologyandOrganTransplantation,UniversityHospitalLeuvenGasthuisberg, Herestraat49,3000Leuven,Belgium 3 4 DepartmentofPediatricNephrology,UniversityHospitalLeuvenGasthuisberg,Herestraat49,3000Leuven,Belgium DepartmentofPediatricUrology,UniversityHospitalLeuvenGasthuisberg,Herestraat49,3000Leuven,Belgium CorrespondenceshouldbeaddressedtoMichielCosters,michiel.costers@uz.kuleuven.ac.be Received30April2008;Revised2July2008;Accepted7July2008 RecommendedbyHiepNguyen The main goal of the management of vesicoureteral re?ux (VUR) is prevention of recurrent urinary tract infections (UTIs), andtherebypreventionofrenalparenchymaldamagepossiblyensuingfromtheseinfections.Long-termantibioticprophylaxisis commonpracticeinthemanagementofchildrenwithVUR,asrecommendedin1997intheguidelinesoftheAmericanUrological Association.WeperformedasystematicreviewtoascertainwhetherantibioticscanbesafelydiscontinuedinchildrenwithVUR andwhetherprophylaxisise?ectiveinthepreventionofrecurrentUTIsandrenaldamageinthesepatients.Severaluncontrolled studiesindicatethatantibioticprophylaxiscanbediscontinuedinasubsetofpatients,thatis,school-agedchildrenwithlow- gradeVUR,normalvoidingpatterns,kidneyswithouthydronephrosisorscars,andnormalanatomyoftheurogenitalsystem. Furthermore,afewrecentrandomizedcontrolledtrialssuggestthatantibioticprophylaxiso?ersnoadvantageoverintermittent antibiotictherapyofUTIsintermsofpreventionofrecurrentUTIsornewrenaldamage. Copyright?2008MichielCostersetal. This is an open access article distributed under the Creative Commons Attribution License,whichpermitsunrestricteduse,distribution,an