Antibiotic Prophylaxis and Recurrent Urinary Tract Infection in Children
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Craig, Jonathan; Simpson, Judy M; Williams, Gabrielle; Lowe, Alison; Reynolds, Graham; McTaggart, Steven; Hodson, Elisabeth; Carapetis, Jonathan; Cranswick, Noel; Smith, Grahame; Irwig, Les; Caldwell, Patrina; Hamilton, Sana; Roy, Leslie
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BACKGROUND: Antibiotics are widely administered to children with the intention of preventing urinary tract infection, but adequately powered, placebo-controlled trials regarding efficacy are lacking. This study from four Australian centers examined whether low-dose, continuous oral antibiotic therapy prevents urinary tract infection in predisposed children. METHODS: We randomly assigned children under the age of 18 years who had had one or more microbiologically proven urinary tract infections...[Show more]
dc.contributor.author | Craig, Jonathan | |
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dc.contributor.author | Simpson, Judy M | |
dc.contributor.author | Williams, Gabrielle | |
dc.contributor.author | Lowe, Alison | |
dc.contributor.author | Reynolds, Graham | |
dc.contributor.author | McTaggart, Steven | |
dc.contributor.author | Hodson, Elisabeth | |
dc.contributor.author | Carapetis, Jonathan | |
dc.contributor.author | Cranswick, Noel | |
dc.contributor.author | Smith, Grahame | |
dc.contributor.author | Irwig, Les | |
dc.contributor.author | Caldwell, Patrina | |
dc.contributor.author | Hamilton, Sana | |
dc.contributor.author | Roy, Leslie | |
dc.date.accessioned | 2015-12-08T22:45:44Z | |
dc.identifier.issn | 0028-4793 | |
dc.identifier.uri | http://hdl.handle.net/1885/37849 | |
dc.description.abstract | BACKGROUND: Antibiotics are widely administered to children with the intention of preventing urinary tract infection, but adequately powered, placebo-controlled trials regarding efficacy are lacking. This study from four Australian centers examined whether low-dose, continuous oral antibiotic therapy prevents urinary tract infection in predisposed children. METHODS: We randomly assigned children under the age of 18 years who had had one or more microbiologically proven urinary tract infections to receive either daily trimethoprim-sulfamethoxazole suspension (as 2 mg of trimethoprim plus 10 mg of sulfamethoxazole per kilogram of body weight) or placebo for 12 months. The primary outcome was microbiologically confirmed symptomatic urinary tract infection. Intention-to-treat analyses were performed with the use of time-to-event data. RESULTS: From December 1998 to March 2007, a total of 576 children (of 780 planned) underwent randomization. The median age at entry was 14 months; 64% of the patients were girls, 42% had known vesicoureteral reflux (at least grade III in 53% of these patients), and 71% were enrolled after the first diagnosis of urinary tract infection. During the study, urinary tract infection developed in 36 of 288 patients (13%) in the group receiving trimethoprim-sulfamethoxazole (antibiotic group) and in 55 of 288 patients (19%) in the placebo group (hazard ratio in the antibiotic group, 0.61; 95% confidence interval, 0.40 to 0.93; P = 0.02 by the log-rank test). In the antibiotic group, the reduction in the absolute risk of urinary tract infection (6 percentage points) appeared to be consistent across all subgroups of patients (P≥0.20 for all interactions). CONCLUSIONS: Long-term, low-dose trimethoprim-sulfamethoxazole was associated with a decreased number of urinary tract infections in predisposed children. The treatment effect appeared to be consistent but modest across subgroups. (Australian New Zealand Clinical Trials Registry number, ACTRN12608000470392.) | |
dc.publisher | Massachusetts Medical Society | |
dc.source | New England Journal of Medicine | |
dc.subject | Keywords: cotrimoxazole; placebo; adolescent; adult; antibiotic prophylaxis; article; child; clinical trial; controlled clinical trial; controlled study; drug withdrawal; female; fever; human; infection risk; long term care; low drug dose; major clinical study; mal | |
dc.title | Antibiotic Prophylaxis and Recurrent Urinary Tract Infection in Children | |
dc.type | Journal article | |
local.description.notes | Imported from ARIES | |
local.identifier.citationvolume | 361 | |
dc.date.issued | 2009 | |
local.identifier.absfor | 119999 - Medical and Health Sciences not elsewhere classified | |
local.identifier.ariespublication | u4201517xPUB154 | |
local.type.status | Published Version | |
local.contributor.affiliation | Craig, Jonathan, University of Sydney | |
local.contributor.affiliation | Simpson, Judy M, University of Sydney | |
local.contributor.affiliation | Williams, Gabrielle, University of Sydney | |
local.contributor.affiliation | Lowe, Alison, Westmead Hospital | |
local.contributor.affiliation | Reynolds, Graham, College of Medicine, Biology and Environment, ANU | |
local.contributor.affiliation | McTaggart, Steven, University of Queensland | |
local.contributor.affiliation | Hodson, Elisabeth, Westmead Hospital | |
local.contributor.affiliation | Carapetis, Jonathan, Charles Darwin University | |
local.contributor.affiliation | Cranswick, Noel, University of Melbourne | |
local.contributor.affiliation | Smith, Grahame , Westmead Hospital | |
local.contributor.affiliation | Irwig, Les, University of Sydney | |
local.contributor.affiliation | Caldwell, Patrina, Westmead Hospital | |
local.contributor.affiliation | Hamilton, Sana, Westmead Hospital | |
local.contributor.affiliation | Roy, Leslie, Westmead Hospital | |
local.description.embargo | 2037-12-31 | |
local.bibliographicCitation.issue | 18 | |
local.bibliographicCitation.startpage | 1748 | |
local.bibliographicCitation.lastpage | 1759 | |
local.identifier.doi | 10.1056/NEJMoa0902295 | |
dc.date.updated | 2016-02-24T10:40:48Z | |
local.identifier.scopusID | 2-s2.0-70350547775 | |
local.identifier.thomsonID | 000271185600007 | |
Collections | ANU Research Publications |
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