Girls and renal scarring as risk factors for febrile urinary tract infection after stopping antibiotic prophylaxis in children with vesicoureteral reflux

Nakamura, Michiko; Moriya, Kimihiko; Kon, Masafumi; Nishimura, Yoko; Chiba, Hiroki; Kitta, Takeya; Shinohara, Nobuo

Girls and renal scarring as risk factors for febrile urinary tract infection after stopping antibiotic prophylaxis in children with vesicoureteral reflux

Nakamura, Michiko; Moriya, Kimihiko; Kon, Masafumi et al.

World journal of urology, 2021, 39, 2587-2595

Permalink : https://hdl.handle.net/2115/86235

このアイテムのアクセス数:422件（2026-01-14 12:35 集計）

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アクセス権	open access
URI	https://hdl.handle.net/2115/86235
タイトル	Girls and renal scarring as risk factors for febrile urinary tract infection after stopping antibiotic prophylaxis in children with vesicoureteral reflux
著者	Nakamura, Michiko ; Moriya, Kimihiko ; Kon, Masafumi ; Nishimura, Yoko ; Chiba, Hiroki ; Kitta, Takeya ; Shinohara, Nobuo
e-Rad_Researcher 60571718 著者名 Nakamura, Michiko
e-Rad_Researcher 20374233 著者名 Moriya, Kimihiko
e-Rad_Researcher 40802799 著者名 Kon, Masafumi
著者名 Nishimura, Yoko
著者名 Chiba, Hiroki
e-Rad_Researcher 40374441 著者名 Kitta, Takeya
e-Rad_Researcher 90250422 著者名 Shinohara, Nobuo
言語	英語
キーワード	Vesicoureteral reflux
	Continuous antibiotic prophylaxis
	Febrile urinary tract infection
	Risk factor
発行日	2021-07
出版者	Springer
収録物名	World journal of urology
巻(号)	39
ページ	2587-2595
抄録	Purpose To clarify the incidence of and risk factors for febrile urinary tract infection in children with persistent vesicoureteral reflux (VUR) after the discontinuation of continuous antibiotic prophylaxis (CAP), retrospective chart review was performed. Patients and methods Among children with primary VUR at 10 years of age or younger at presentation, those who had persistent VUR despite conservative management with CAP and who were subsequently followed after discontinuation of CAP were included. Kaplan-Meier curve and Cox's proportional hazard regression model were used for evaluation of the incidence of and risk factors for febrile urinary tract infection (fUTI) after stopping CAP. Results Among 144 children (99 boys and 45 girls), fUTI developed in 34. The 5-year fUTI-free rate after discontinuation of CAP was 69.4%. On multivariate analyses, girls (p = 0.008) and abnormalities on nuclear renal scans (p = 0.0019), especially focal defect (p = 0.0471), were significant factors for fUTI. Although the fUTI-free rate was not different between children who had no or 1 risk factor, it was significantly lower in children with 2 risk factors than in those with no or 1 risk factor. Conclusions The present study revealed that girls and abnormal renal scan, especially focal defect, are risk factors for fUTI. Active surveillance without CAP for persistent VUR seems to be a safe option for children with no or 1 risk factor. Prophylactic surgery or careful conservative follow-up may be an option for girls with abnormal renal scan results if VUR persists under CAP.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	This is a post-peer-review, pre-copyedit version of an article published in World journal of urology. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00345-020-03524-1
PISSN	0724-4983
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1007/s00345-020-03524-1