What is antibiotic prophylaxis?
The recommended first-line treatment for VUR is to put the child on antibiotics to prevent UTIs. Typically, this involves taking a low dose of antibiotics once or twice a day, every day.
This is called antibiotic prophylaxis. With this treatment option, the doctor tries to protect the child from UTIs while waiting for the VUR to go away by itself (spontaneous resolution).
What are the pros and cons of antibiotic treatment?
The main advantage of antibiotic prophylaxis is that it is the least invasive treatment option for the child. The challenge for parents is to ensure that the child takes their daily dosage of antibiotics. Some find this quite challenging. In one study, the majority of patients (82%) tested negative for antibiotics following 12 months antibiotic prophylaxis.1
Once on antibiotic prophylaxis, your child will usually be tested with a VCUG each year to monitor the grade of VUR. Other tests may be required as well.
Also, any time the child displays any of the symptoms of a UTI, the parents are usually instructed to bring the child to the hospital immediately for urine tests to see if there is a UTI. When an infection occurs while the child is on antibiotic prophylaxis, doctors refer to it as a breakthrough infection. Breakthrough infections require immediate action to avoid the risk of kidney damage.
Another issue that concerns some parents about antibiotic prophylaxis is the risk of antibiotic resistance — that is the bacteria become resistant to the low dose of antibiotics over time so that the antibiotics are no longer effective on the child.
Panaretto KS, Craig JC, Knight JF, et al. Risk factors for recurrent urinary tract infection in preschool children. J Paediatric Child Health 1999; 35: 454-9