Antibiotics (Jun 2023)
Antibiotic Prophylaxis for the Prevention of Urinary Tract Infections in Children: Guideline and Recommendations from the Emilia-Romagna Pediatric Urinary Tract Infections (UTI-Ped-ER) Study Group
- Giovanni Autore,
- Luca Bernardi,
- Filippo Ghidini,
- Claudio La Scola,
- Alberto Berardi,
- Giacomo Biasucci,
- Federico Marchetti,
- Andrea Pasini,
- Maria Elena Capra,
- Claudia Castellini,
- Vera Cioni,
- Sante Cantatore,
- Andrea Cella,
- Francesca Cusenza,
- Alessandro De Fanti,
- Elisa Della Casa Muttini,
- Margherita Di Costanzo,
- Alessandra Dozza,
- Claudia Gatti,
- Cristina Malaventura,
- Luca Pierantoni,
- Giovanni Parente,
- Gabriella Pelusi,
- Serafina Perrone,
- Laura Serra,
- Francesco Torcetta,
- Enrico Valletta,
- Gianluca Vergine,
- Francesco Antodaro,
- Andrea Bergomi,
- Jennifer Chiarlolanza,
- Laura Leoni,
- Franco Mazzini,
- Roberto Sacchetti,
- Agnese Suppiej,
- Lorenzo Iughetti,
- Andrea Pession,
- Mario Lima,
- Susanna Esposito,
- The UTI-Ped-ER Study Group
Affiliations
- Giovanni Autore
- Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Luca Bernardi
- Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Filippo Ghidini
- Pediatric Surgery, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Claudio La Scola
- Pediatric Clinic, IRCCS Azienda Ospedaliera Universitaria di Bologna, 40138 Bologna, Italy
- Alberto Berardi
- Neonatology and Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Giacomo Biasucci
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29122 Piacenza, Italy
- Federico Marchetti
- Pediatrics and Neonatology Unit, Ravenna Hospital, AUSL Romagna, 48121 Ravenna, Italy
- Andrea Pasini
- Pediatric Clinic, IRCCS Azienda Ospedaliera Universitaria di Bologna, 40138 Bologna, Italy
- Maria Elena Capra
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29122 Piacenza, Italy
- Claudia Castellini
- Pediatric Unit, Carpi Hospital, AUSL Modena, 41012 Carpi, Italy
- Vera Cioni
- Pediatric Unit, Sassuolo Hospital, AUSL Modena, 41049 Sassuolo, Italy
- Sante Cantatore
- Pediatrics Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Andrea Cella
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29122 Piacenza, Italy
- Francesca Cusenza
- Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Alessandro De Fanti
- Pediatrics Unit, Santa Maria Nuova Hospital, AUSL-IRCCS of Reggio Emilia, 42123 Reggio Emilia, Italy
- Elisa Della Casa Muttini
- Neonatology and Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Margherita Di Costanzo
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29122 Piacenza, Italy
- Alessandra Dozza
- Pediatric Unit, Pavullo Hospital, AUSL Modena, 41026 Pavullo, Italy
- Claudia Gatti
- Pediatric Surgery, University Hospital, 43126 Parma, Italy
- Cristina Malaventura
- Pediatric Clinic, University of Ferrara, 44124 Ferrara, Italy
- Luca Pierantoni
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliera Universitaria di Bologna, 40138 Bologna, Italy
- Giovanni Parente
- Pediatric Surgery, IRCCS Azienda Ospedaliera Universitaria di Bologna, 40138 Bologna, Italy
- Gabriella Pelusi
- Pediatrics Surgery, Rimini Hospital, AUSL Romagna, 47921 Rimini, Italy
- Serafina Perrone
- Neonatology Unit, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Laura Serra
- Pediatric Unit, Imola Hospital, AUSL Imola, 40026 Imola, Italy
- Francesco Torcetta
- Pediatric Unit, Carpi Hospital, AUSL Modena, 41012 Carpi, Italy
- Enrico Valletta
- Pediatric Unit, Forlì Hospital, AUSL Romagna, 47122 Forlì, Italy
- Gianluca Vergine
- Pediatric Clinic, Rimini Hospital, AUSL Romagna, 47921 Rimini, Italy
- Francesco Antodaro
- Primary Care Pediatrician, AUSL Modena, 41125 Modena, Italy
- Andrea Bergomi
- Primary Care Pediatrician, AUSL Modena, 41125 Modena, Italy
- Jennifer Chiarlolanza
- Primary Care Pediatrician, AUSL Modena, 41125 Modena, Italy
- Laura Leoni
- Primary Care Pediatrician, AUSL Parma, 43126 Parma, Italy
- Franco Mazzini
- Primary Care Pediatrician, AUSL Romagna, 47521 Cesena, Italy
- Roberto Sacchetti
- Primary Care Pediatrician, AUSL Piacenza, 29121 Piacenza, Italy
- Agnese Suppiej
- Pediatric Clinic, University of Ferrara, 44124 Ferrara, Italy
- Lorenzo Iughetti
- Pediatrics Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Andrea Pession
- Pediatric Clinic, IRCCS Azienda Ospedaliera Universitaria di Bologna, 40138 Bologna, Italy
- Mario Lima
- Pediatric Surgery, IRCCS Azienda Ospedaliera Universitaria di Bologna, 40138 Bologna, Italy
- Susanna Esposito
- Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- The UTI-Ped-ER Study Group
- DOI
- https://doi.org/10.3390/antibiotics12061040
- Journal volume & issue
-
Vol. 12,
no. 6
p. 1040
Abstract
Background: Urinary tract infection (UTI) represents one of the most common infectious diseases and a major cause of antibiotic prescription in children. To prevent recurrent infections and long-term complications, low-dose continuous antibiotic prophylaxis (CAP) has been used. However, the efficacy of CAP is controversial. The aim of this document was to develop updated guidelines on the efficacy and safety of CAP to prevent pediatric UTIs. Methods: A panel of experts on pediatric infectious diseases, pediatric nephrology, pediatric urology, and primary care was asked clinical questions concerning the role of CAP in preventing UTIs in children. Overall, 15 clinical questions were addressed, and the search strategy included accessing electronic databases and a manual search of gray literature published in the last 25 years. After data extraction and narrative synthesis of results, recommendations were developed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) methodology. Results: The use of CAP is not recommended in children with a previous UTI, with recurrent UTIs, with vesicoureteral reflux (VUR) of any grade, with isolated hydronephrosis, and with neurogenic bladder. CAP is suggested in children with significant obstructive uropathies until surgical correction. Close surveillance based on early diagnosis of UTI episodes and prompt antibiotic therapy is proposed for conditions in which CAP is not recommended. Conclusions: Our systematic review shows that CAP plays a limited role in preventing recurrences of UTI in children and has no effect on its complications. On the other hand, the emergence of new antimicrobial resistances is a proven risk.
Keywords
- antibiotic prophylaxis
- antibiotic resistance
- obstructive uropathies
- pediatrics
- urinary tract infection
