Antibiotic Prophylaxis in Pediatric Urology: An Update

This article discusses the use of antibiotic prophylaxis in the treatment of three common conditions encountered by the pediatric urologist: 1) children with urinary infection and structurally and neurologically normal urinary tracts; 2) children with vesicoureteral reflux (VUR); and 3) children with prenatally diagnosed ureteropelvic and ureterovesical obstruction. The literature remains unclear and contradictory. Additional significant risk factors for recurrent infection are age, circumcision status in boys, and toileting function. The evidence for the use of prophylaxis is best in those with VUR, although not everyone with VUR must be on medication. In the absence of definitive evidence, the clinician must individualize the treatment of each patient and family.