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Intermittent trimethoprim-sulfamethoxazole in children with vesicoureteral reflux.

Abstract
The effectiveness of intermittent low-dose trimethoprim-sulfamethoxazole (TMP-SMZ) for the prophylaxis of recurrent urinary infection is well established in adults. The present study assessed the effectiveness and safety of intermittent low-dose TMP-SMZ in 35 children (24 boys, 11 girls, aged 1 month to 9 years, median age 5 months) with vesicoureteral reflux; 18 children had bilateral reflux. A total of 53 refluxing ureters were graded as I in 2, II in 16, III in 19, IV in 14, and V in 2 cases. The children were given 1 mg/kg body weight of trimethoprim together with 5 mg/kg of sulfamethoxazole at bedtime every other day for 6-50 months (mean +/- SD, 22.9 +/- 11.7 months). None of the boys had a recurrence of urinary infection, while 2 of the 11 girls had a total of 7 recurrences during the prophylaxis period, with a recurrence rate of 0.027 per patient month in girls. Both girls were over 3 years and had a mildly unstable bladder. Transient neutropenia (< 1,000/microliter) developed in 2 infants during the prophylaxis period, but disappeared spontaneously. Intermittent low-dose TMP-SMZ seemed very effective for the prevention of recurrent urinary infection in children with ureteral reflux even of higher grades.
AuthorsC Hori, M Hiraoka, H Tsukahara, S Tsuchida, M Sudo
JournalPediatric nephrology (Berlin, Germany) (Pediatr Nephrol) Vol. 11 Issue 3 Pg. 328-30 (Jun 1997) ISSN: 0931-041X [Print] Germany
PMID9203183 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Anti-Infective Agents, Urinary
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Creatinine
Topics
  • Anti-Infective Agents, Urinary (adverse effects, therapeutic use)
  • Child
  • Child, Preschool
  • Creatinine (blood, urine)
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Kidney Function Tests
  • Male
  • Trimethoprim, Sulfamethoxazole Drug Combination (adverse effects, therapeutic use)
  • Urinary Tract Infections (etiology, prevention & control)
  • Vesico-Ureteral Reflux (complications)

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