Have we overtreated children with vesicoureteric reflux?

被引：0
作者：
John Lazarus
机构：
[1] University of Cape Town,Departments of Paediatric Urology, Red Cross Children’s Hospital
来源：
African Journal of Urology | 2010年 / 16卷 / 4期
关键词：
Vesicoureteric reflux; children; etiology; pathophysiology; investigation; managment;
D O I：
10.1007/s12301-010-0023-6
中图分类号：
学科分类号：
摘要：
Urinary tract infections (UTI) are the most common serious bacterial infections in young children. These UTIs have a high association with vesicoureteric reflux (VUR). The pathophysiology of VUR’s renal sequelae, its investigation and management is presently undergoing a reassessment. This review documents these changes focusing on compelling new data. With regard to the need for and benefit of imaging procedures in children with UTIs we present an algorithm for investigation that is tailored to the African context. The value of continuous antibiotic prophylaxis is questioned and the role of injectable ureteric bulking is discussed with reference to the Swedish Reflux Trial.
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页码：103 / 109
页数：6
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  • [1] Weiss R.(1981)A prospective international reflux study in children J.Urol. 125 277-283
  • [2] Duckett J.(1992)Results of a randomized clinical trial of medical versus surgical management of infants and children with grades III and IV primary vesicoureteral reflux (United States). The international reflux study in children J.Urol. 148 1667-1673
  • [3] Spitzer A.(2009)Antimicrobial prophylaxis for urinary tract infection in children New Engl.J.Med. 361 1804-1806
  • [4] Hoberman A.(2007)Normal dimercaptosuccinic acid scintigraphy makes voiding cystourethrography unnecessary after urinary tract infection J.Pediatr. 151 581-573
  • [5] Keren R.(2000)Outcome of primary vesicoureteric reflux detected following fetal renal pelvic dilatation J.Paediatr.Child Health. 36 569-632
  • [6] Preda I.(2006)Clinical significance of primary vesicoureteral reflux and urinary antibiotic prophylaxis after acute pyelonephritis: A multicenter, randomized, controlled study Pediatrics. 117 626-679
  • [7] Jodal U.(2008)Antibiotic prophylaxis for the prevention of recurrent urinary tract infection in children with low grade vesicoureteral reflux: Results from a prospective randomized study J.Urol. 179 674-e1494
  • [8] Sixt R.(2008)Is antibiotic prophylaxis in children with vesicoureteral reflux effective in preventing pyelonephritis and renal scars? A randomized, controlled trial Pediatrics. 121 e1489-1071
  • [9] Stokland E.(2008)Prophylaxis after first febrile urinary tract infection in children? A multicenter, randomized, controlled, noninferiority trial Pediatrics. 122 1064-99
  • [10] Hansson S.(2004)Radiation protection in humans: Extending the concept of as low as reasonably achievable (ALARA) from dose to biological damage Br.J.Radiol. 77 97-862
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