A new study out of Australia shows that giving children who are predisposed to recurrent urinary tract infections (UTI) preventative antibiotics may have a modest effect.
The study showed that only 13 percent of youngsters who were given the antibiotic combination of trimethoprim plus sulfamethoxazole (brand names Bactrim and Septra) developed a urinary tract infection while on the medication compared to 19 percent of the children on a placebo.
“There was a small benefit across many groups of children, which will be worthwhile in some — e.g., very young children, those with severe infections and those with recurrent infections,” said the study’s lead author, Dr. Jonathan C. Craig, a professor of clinical epidemiology at the School of Public Health at the University of Sydney in Australia. Results of the study are published in the October 29, 2009, issue of the New England Journal of Medicine.
Urinary tract infections are very common in children. According to the study, 2 percent of boys and 8 percent of girls will have at least one UTI by the time they are seven years old. Although often a mild infection, UTIs can be serious, with as many as 5 percent of children with one of these infections developing some type of kidney damage.
The study included children with varying degrees of vesicoureteral reflux, which means urine backs up from the bladder into the kidney, as well as children without this condition. However, all of the children included in the study had had at least one symptomatic UTI.
The median age of the children at the start of the study was 14 months, and they were recruited from four centers in Australia. Just under two-thirds of the children were girls. Half of the children (288) were randomly selected to receive the antibiotic combination preventively for 12 months, while the other youngsters received a placebo for 12 months.
Craig said he believes the modest reduction in urinary tract infections with preventive antibiotic use outweighs the potential risks, such as the possible development of antibiotic-resistant bacteria.
