Physicians must be judicious in the use of a continuous regimen of antibiotics to treat infants and children with vesicoureteral reflux, according to an editorial published by a Wayne State University School of Medicine faculty member this week in the New England Journal of Medicine. 

Tej Mattoo, M.D.

In “Selective Antimicrobial Prophylaxis for Vesicoureteral Reflux,” Tej Mattoo, M.D., professor of Pediatrics and of Urology, examines the findings of a study on the use of antibiotics to treat the condition and the side effects of urinary tract infections in patients.

In “Antibiotic Prophylaxis in Infants with Grade III, IV, or V Vesicoureteral Reflux,” published in the same edition, the authors conclude that in infants with grade III, IV or V vesicoureteral reflux and no previous urinary tract infections, continuous antibiotics provided a “small but significant benefit in preventing” a first UTI despite an increased occurrence of non–E. coli organisms and antibiotic resistance.

Vesicoureteral reflux, generally diagnosed in infants, increases the risk of UTIs. It is distinguished by the abnormal flow of urine from the bladder upstream to kidneys. Left untreated, the condition can lead to kidney damage.

“The results of this trial once again showed that continuous antibiotic prophylaxis significantly reduced the risk of UTI, although not among all children considered en masse and at the expense of increased antimicrobial resistance,” Dr. Mattoo writes.

The key takeaway from the study, Dr. Mattoo writes, “is that continuous antibiotic prophylaxis should be used judiciously.”