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Primer Vezikoüreteral Reflü Profilaksisinde Amoksisilinin Uzun Dönem Etkinliğinin Değerlendirilmesi

Year 2024, , 291 - 293, 30.11.2024
https://doi.org/10.16899/jcm.1537031

Abstract

Amaç: Vezikoüreteral reflü (VUR)’un konservatif tedavisinde antibiyotik profilaksisi uzun zamandan beri kullanılmaktadır. Bu çalışmada antibiyotik profilaksis olarak amoksisilinin uzun dönem etkinliği araştırıldı.
Gereç ve Yöntem: VUR tanısı ile takip edilen ve en az 6 ay ve daha uzun süre amoksisilin profilaksisi alan hastaların klinik özellikleri ve izlem sonuçları retrospektif olarak araştırıldı.
Bulgular: Çalışmaya 13’ü kız (%29.5), 31’i erkek (%70.5) olmak üzere 44 hasta alındı ve yaş ortalaması 2.9±1.3 aydı. Ortalama 27.4±19.4 ay takipte 9 hastada (%20.5) bir kez idrar yolu enfeksiyonu (İYE) ve 2 hastada (%4.5) ateşli İYE tespit edildi. İki hasta ateşli İYE, 2 hastada ise gastrointestinal yan etkiler olmak üzere toplam 4 hastada (%9) antibiyotik revizyonu yapıldı.
Sonuç: VUR’lu hastaların amoksisilin profilaksisi ile uzun dönem takibi etkili ve güvenilir bir tedavi seçeneğidir.

References

  • 1. Mattoo TK. Vesicoureteral reflux and reflux nephropathy. Adv Chronic Kidney Dis. 2011;18(5):348-54.
  • 2. Johnston DL, Qureshi AH, Irvine RW, Giel DW, Hains DS. Contemporary Management of Vesicoureteral Reflux. Curr Treat Options Pediatr. 2016;2(2):82-93.
  • 3. Hoberman A, Greenfield SP, Mattoo TK, Keren R, Mathews R, Pohl HG, Kropp BP, Skoog SJ, Nelson CP, Moxey-Mims M, Chesney RW, Carpenter MA. Antimicrobial prophylaxis for children with vesicoureteral reflux N Engl J Med. 2014;370(25):2367-76.
  • 4. Min Xie, Xiaogai Xu, Zhenjie Cao, Huijie Xiao. Do Various Treatment Modalities of Vesicoureteral Reflux Have Any Adverse Effects in Pediatric Patients? A Meta-Analysis. Urol Int. 2021;105(11-12):1002-1010.
  • 5. Läckgren G, Cooper CS, Neveus T, Kirsch AJ. Management of Vesicoureteral Reflux: What Have We Learned Over the Last 20 Years? Front Pediatr. 2021;9:650326.
  • 6. Johnston DL, Qureshi AH, Irvine RW, Giel DW, Hains DS. Contemporary Management of Vesicoureteral Reflux. Curr Treat Options Pediatr. 2016;2(2):82-93.
  • 7. Shaikh N, Lee S, Krumbeck JA, Kurs-Lasky M. Support for the use of a new cutoff to define a positive urine culture in young children. Pediatrics. 2023;152(4):e2023061931.
  • 8. Urine collection methods and dipstick testing in non-toilet-trained children. Diviney J, Jaswon MS. Pediatr Nephrol. 2021;36(7):1697-1708.
  • 9. Miyakita H, Hayashi Y, Mitsui T, Okawada M, Kinoshita Y, Kimata T et al. Guidelines for the medical management of pediatric vesicoureteral reflux. Int J Urol. 2020;27(6):480-490.
  • 10. Rivur Trial Investigators. Hoberman A, Greenfield SP, Mattoo TK, Keren R, Mathews R, et al. Antimicrobial prophylaxis for children with vesicoureteral reflux. N Engl J Med. 2014; 370:2367–76.
  • 11. Brandström P, Esbjörner E, Herthelius M, Swerkersson S, Jodal U, Hansson S. The Swedish reflux trial in children: III. Urinary tract infection pattern. J Urol. 2010;184:286–91.
  • 12. Cendron M. Antibiotic prophylaxis in the management of vesicoureteral reflux. Adv Urol. 2008;2008:825475.

Long-term Effectiveness of Amoxicillin Prophylaxis for Children with Primary Vesicoureteral Reflux

Year 2024, , 291 - 293, 30.11.2024
https://doi.org/10.16899/jcm.1537031

Abstract

Aim: The use of antibiotic prophylaxis in the conservative treatment of vesicoureteral reflux (VUR) has a long historical precedent. In this study, we investigated the long-term efficacy of amoxicillin as antibiotic prophylaxis.
Materials and Methods: A retrospective investigation was conducted to examine the clinical characteristics and follow-up results of patients with VUR who received amoxicillin prophylaxis for at least of six months.
Results: A total of 44 patients were included in the study, comprising 13 girls (29.5%) and 31 boys (70.5%), with a mean age of 2.9±1.3 months. During a mean follow-up period of 27.4±19.4 months, nine patients (20.5%) experienced one urinary tract infection (UTI), while two patients (4.5%) had a febrile UTI. Antibiotic revision was performed in a total of four patients (9%), including two patients with a febrile UTI and two patients with gastrointestinal side effects.
Conclusion: The long-term follow-up of patients with VUR who have been treated with amoxicillin prophylaxis has demonstrated that this is an effective and safe treatment option.

References

  • 1. Mattoo TK. Vesicoureteral reflux and reflux nephropathy. Adv Chronic Kidney Dis. 2011;18(5):348-54.
  • 2. Johnston DL, Qureshi AH, Irvine RW, Giel DW, Hains DS. Contemporary Management of Vesicoureteral Reflux. Curr Treat Options Pediatr. 2016;2(2):82-93.
  • 3. Hoberman A, Greenfield SP, Mattoo TK, Keren R, Mathews R, Pohl HG, Kropp BP, Skoog SJ, Nelson CP, Moxey-Mims M, Chesney RW, Carpenter MA. Antimicrobial prophylaxis for children with vesicoureteral reflux N Engl J Med. 2014;370(25):2367-76.
  • 4. Min Xie, Xiaogai Xu, Zhenjie Cao, Huijie Xiao. Do Various Treatment Modalities of Vesicoureteral Reflux Have Any Adverse Effects in Pediatric Patients? A Meta-Analysis. Urol Int. 2021;105(11-12):1002-1010.
  • 5. Läckgren G, Cooper CS, Neveus T, Kirsch AJ. Management of Vesicoureteral Reflux: What Have We Learned Over the Last 20 Years? Front Pediatr. 2021;9:650326.
  • 6. Johnston DL, Qureshi AH, Irvine RW, Giel DW, Hains DS. Contemporary Management of Vesicoureteral Reflux. Curr Treat Options Pediatr. 2016;2(2):82-93.
  • 7. Shaikh N, Lee S, Krumbeck JA, Kurs-Lasky M. Support for the use of a new cutoff to define a positive urine culture in young children. Pediatrics. 2023;152(4):e2023061931.
  • 8. Urine collection methods and dipstick testing in non-toilet-trained children. Diviney J, Jaswon MS. Pediatr Nephrol. 2021;36(7):1697-1708.
  • 9. Miyakita H, Hayashi Y, Mitsui T, Okawada M, Kinoshita Y, Kimata T et al. Guidelines for the medical management of pediatric vesicoureteral reflux. Int J Urol. 2020;27(6):480-490.
  • 10. Rivur Trial Investigators. Hoberman A, Greenfield SP, Mattoo TK, Keren R, Mathews R, et al. Antimicrobial prophylaxis for children with vesicoureteral reflux. N Engl J Med. 2014; 370:2367–76.
  • 11. Brandström P, Esbjörner E, Herthelius M, Swerkersson S, Jodal U, Hansson S. The Swedish reflux trial in children: III. Urinary tract infection pattern. J Urol. 2010;184:286–91.
  • 12. Cendron M. Antibiotic prophylaxis in the management of vesicoureteral reflux. Adv Urol. 2008;2008:825475.
There are 12 citations in total.

Details

Primary Language English
Subjects Pediatric Nephrology
Journal Section Original Research
Authors

Ahmet Midhat Elmacı 0000-0002-4011-6919

Early Pub Date November 29, 2024
Publication Date November 30, 2024
Submission Date August 24, 2024
Acceptance Date October 11, 2024
Published in Issue Year 2024

Cite

AMA Elmacı AM. Long-term Effectiveness of Amoxicillin Prophylaxis for Children with Primary Vesicoureteral Reflux. J Contemp Med. November 2024;14(6):291-293. doi:10.16899/jcm.1537031