ESPU Congress 2017 - Abstract book

CONGRESS OF THE ESPU

08:38–08:41

S4-4 (PP)

IMPACT OF PROPHYLACTIC ANTIBIOTICS SUSCEPTIBILITY

OF INITIAL UTI IN CHILDREN WITH VESICOURETERAL

REFLUX RECEIVING CONTINUOUS ANTIBIOTIC

PROPHYLAXIS

Jae-Wook CHUNG, Jun Nyung LEE, Yun-Sok HA and Sung Kwang CHUNG

Kyungpook National University School of Medicine, Urology, Daegu, REPUBLIC OF KOREA

PURPOSE

Recent several studies have demonstrated that effectiveness of continuous antibiotic prophylaxis

(CAP) for vesicoureteral reflux (VUR). However there were few studies for clinical outcome associ-

ated with antibiotic resistance of initial urinary tract infection (UTI) in children VUR receiving CAP.

We assessed the effect of antibiotic resistance of initial UTI on the clinical outcome after CAP for

VUR.

MATERIAL AND METHODS

We retrospectively reviewed the medical records of 81 primary VUR children who diagnosed after

fUTI between January 2010 and December 2013. All children received trimethoprim-sulfamethox-

azole (TMP-SMX) as CAP. Base on TMP-SMX susceptibility of initial UTI, we allocated the VUR

children to a susceptible group or a resistant group and evaluated the patients’ demographics and

outcomes after CAP according to TMP-SMX susceptibility of initial UTI. Multivariate analysis was

used to assess breakthrough fUTI recurrence after CAP for VUR.

RESULTS

Of the 81 children, 42 were classified as the susceptible group and 39 were placed in the resistant

group. The breakthrough fUTI was observed 53.8% (21/39) in the resistant group and 31.0% (13/42)

in susceptible group (p = 0.037). Progression of renal scarring was observed in 0% of children in the

susceptible group and 15% in the resistance group (p = 0.053). TMP-SMX resistance (HR=2.947,

95% CI=1.137-7.636) and renal scarring at diagnosis (HR=3.263, 95% CI=1.133-9.402) were

significant predictors of breakthrough fUTI on multivariate analysis.

CONCLUSIONS

Prophylactic antibiotics susceptibility of initial UTI is a risk factor of breakthrough fUTI and associ-

ated with poor clinical outcome in children with VUR receiving CAP.