Antibiotics May Not Prevent Recurrence of Urinary Tract Infections in Children

Contrary to previous medical thought, giving children daily doses of antibiotics to prevent urinary tract infections may not have a protective effect, as previously described in the medical literature. In fact, daily antibiotics may cause harm to children by promoting the growth of resistant bacteria in the urinary tract which would be difficult to treat with standard antibiotics. The results of this latest study will be published in JAMA (Journal of the American Medical Association) this month.

In this particular study, 75,000 children, ranging in ages from infancy to age 6, were chosen from 27 pediatric offices in three states. Children were chosen who had had a first urinary tract infection between the years of 2001 and 2006. The records were analyzed to determine what risk factors affected the risk for recurrent urinary tract infections during that observed time period, including the use of antibiotic prophylaxis.

The researchers were surprised to learn that antibiotic prophylaxis offered no protection against recurrent urinary tract infections in these children and also seemed to increase the risk of infection with bacteria resistant to standard antibiotics. The also found that children between the ages of 2 and 6 had a higher risk of developing a subsequent urinary tract infection when compared to children under 2 years of age.Nonwhite children tended to have a lower incidence of recurrent urinary tract infections, but were at a higher risk of developing an antibiotic resistant infection.

Previously, daily preventive antibiotics have been prescribed by doctors for children who have a condition called vesicoureteral reflux, a condition that causes the urine to flow backwards from the bladder to the kidneys. This condition carries with it an increased risk of urinary tract infection. Because recurrent urinary tract infections can cause scarring of the kidneys, it was felt antibiotics might play a role in preventing this undesirable outcome.