Childhood UTI antibiotics may have unacceptable side effects
Long-term antibiotic use for the prevention of urinary tract infections (UTIs) in children may cause unacceptable side effects.
A Cochrane
Database Review considered three trials involving a total
of 151 patients, comparing antibiotic use with placebo or no treatment.
The duration of antibiotic prophylaxis treatment varied from 10 weeks
to 12 months.
The overall rate of recurrent UTI in the placebo/no treatment group was
63 per cent. Compared with placebo/no treatment, antibiotics reduced
the risk of recurrent UTI (relative risk 0.36, 95 per cent confidence
interval 0.16–0.77). No side effects were described in any of these
three trials.
One double-blind trial (n=120) reported that nitrofurantoin was more
effective than trimethoprim in recurrent UTI prevention over a six-month
period (relative risk 0.48, 95 per cent CI 0.25–0.92).
However, patients receiving nitrofurantoin were more likely to discontinue
the antibiotic due to side effects (mainly gastrointestinal) than patients
receiving trimethoprim (relative risk 3.17, 95 per cent CI 1.36–7.37).
By the age of seven years, 8.4 per cent of girls and 1.7 per cent of
boys will have suffered at least one UTI episode.
The authors conclude that most published studies to date have been poorly
designed, and were likely to overestimate the true treatment effect.
The review found evidence to indicate that some antibiotics were effective,
but that the side effects (including vomiting) associated with many others
were too frequent to justify their use in this setting. |
The
Pharmaceutical Journal
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