Comparing Intermittent and Continuous Antibiotic Administrations for the Treatment of Children with Vesicoureteral Reflux

Background: Vesicoureteral reflux (VUR) is a high-prevalence and dangerous urinary system disorder. So, this study was performed to investigate the comparison between intermittent and continuous administration of antibiotics for the treatment of children with VUR. Methods: In this study, ۲۷ children with VUR referred to a nephrology clinic were included in the study. Children received cephalexin at ۱۵ mg/kg once a day for ۶ months, and after a ۴۸-hour washout period, children received cephalexin at ۱۵ mg/kg intermittently every other day for ۶ months. Before the start of each treatment period, kidney and urinary tract ultrasounds and urine tests were performed for patients. In case of fever, dysuria, and frequent urination, urine test and culture were performed immediately, and in case of no symptoms, urine test and culture were performed monthly. Results: Out of ۲۷ children, ۴ children (۱۴.۸%) had abnormal dimercaptosuccinic acid (DMSA) results, ۱۸ (۶۶.۷%) had bladder reflux grade ۴-۵, ۹ (۳۳.۳%) were less than ۱۲ months, and ۴ (۱۴.۸%) had recurrent urinary tract infections (UTI). The incidences of urinary tract infection did not differ, significantly, in continuous and intermittent antibiotic treatments (p>۰.۰۵). There were no ultrasound changes after the treatment period. Conclusion: There was no difference between intermittent and continuous administrations of antibiotics in the improvement of UTI symptoms in children with VUR. Therefore, the intermittent method can be used as a method with fewer toxicity or adverse effects in the treatment of these patients due to lower doses of antibiotic administration.

Keywords:

Antibiotic , , , , , urinary tract infection , , , , , vesicoureteral reflux