{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T15:39:12Z","timestamp":1790177952853,"version":"4.1.0"},"reference-count":22,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>CONTEXT:<\/jats:title>\n                    <jats:p>Acute pyelonephritis may result in renal scarring. Recent prospective studies have shown a small benefit of antibiotic prophylaxis in preventing symptomatic and febrile urinary tract infections (UTIs), while being underpowered to detect any influence in prevention of renal damage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>Review of the literature and a meta-analysis to evaluate the effect of antibiotic prophylaxis on UTI-related renal scarring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DATA SOURCES:<\/jats:title>\n                    <jats:p>Medline, Embase, and Cochrane Controlled Trials Register electronic databases were searched for studies published in any language and bibliographies of identified prospective randomized controlled trials (RCTs) performed and published between 1946 and August 2016.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY SELECTION:<\/jats:title>\n                    <jats:p>Subjects 18 years of age or younger with symptomatic or febrile UTIs, enrolled in prospective RCTs of antibiotic prophylaxis where 99mTc dimercaptosuccinic acid scans were performed at entry into the study and at late follow-up to detect new scar formation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DATA EXTRACTION:<\/jats:title>\n                    <jats:p>The literature search, study characteristics, inclusion and exclusion criteria, and risk of bias assessment were independently evaluated by 2 authors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Seven RCTs (1427 subjects) were included in the meta-analysis. Our results show no influence of antibiotic prophylaxis in preventing renal scarring (pooled risk ratio, 0.83; 95% confidence interval, 0.55\u20131.26) as did a subanalysis restricted to those subjects with vesicoureteral reflux (pooled risk ratio, 0.79; 95% confidence interval, 0.51\u20131.24).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LIMITATIONS:<\/jats:title>\n                    <jats:p>Limitations include the small number of studies, short duration of follow-up, and insufficient children with high-grade dilating reflux and\/or renal dysplasia enrolled in the studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Antibiotic prophylaxis is not indicated for the prevention of renal scarring after a first or second symptomatic or febrile UTI in otherwise healthy children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2016-3145","type":"journal-article","created":{"date-parts":[[2017,4,6]],"date-time":"2017-04-06T05:10:14Z","timestamp":1491455414000},"source":"Crossref","is-referenced-by-count":89,"title":["Antibiotic Prophylaxis for Urinary Tract Infection\u2013Related Renal Scarring: A Systematic Review"],"prefix":"10.1542","volume":"139","author":[{"given":"Ian K.","family":"Hewitt","sequence":"first","affiliation":[{"name":"Department of Paediatric Nephrology, Princess Margaret Hospital for Children, Perth, Western Australia, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Pennesi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Morello","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology, Dialysis and Transplant Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Ronfani","sequence":"additional","affiliation":[{"name":"Epidemiology and Biostatistics Unit, Institute for Maternal and Child Health \u2013 IRCCS \u201cBurlo Garofolo,\u201d Trieste, Italy; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Montini","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology, Dialysis and Transplant Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2017,5,1]]},"reference":[{"issue":"8","key":"2021121018424260900_B1","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1007\/s00467-015-3168-5","article-title":"Acute pyelonephritis in children.","volume":"31","author":"Morello","year":"2016","journal-title":"Pediatr Nephrol"},{"issue":"10","key":"2021121018424260900_B2","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1001\/jamapediatrics.2014.637","article-title":"Identification of children and adolescents at risk for renal scarring after a first urinary tract infection: a meta-analysis with individual patient data.","volume":"168","author":"Shaikh","year":"2014","journal-title":"JAMA Pediatr"},{"issue":"25","key":"2021121018424260900_B3","doi-asserted-by":"crossref","first-page":"2367","DOI":"10.1056\/NEJMoa1401811","article-title":"Antimicrobial prophylaxis for children with vesicoureteral reflux.","volume":"370","author":"Hoberman","year":"2014","journal-title":"N Engl J Med"},{"issue":"3","key":"2021121018424260900_B4","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/j.juro.2014.08.112","article-title":"Efficacy of antibiotic prophylaxis in children with vesicoureteral reflux: systematic review and meta-analysis.","volume":"193","author":"Wang","year":"2015","journal-title":"J Urol"},{"issue":"7","key":"2021121018424260900_B5","doi-asserted-by":"crossref","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med"},{"key":"2021121018424260900_B6","doi-asserted-by":"crossref","first-page":"d5928","DOI":"10.1136\/bmj.d5928","article-title":"The Cochrane Collaboration\u2019s tool for assessing risk of bias in randomised trials.","volume":"343","author":"Higgins","year":"2011","journal-title":"BMJ"},{"issue":"3","key":"2021121018424260900_B7","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1542\/peds.2005-1362","article-title":"Clinical significance of primary vesicoureteral reflux and urinary antibiotic prophylaxis after acute pyelonephritis: a multicenter, randomized, controlled study.","volume":"117","author":"Garin","year":"2006","journal-title":"Pediatrics"},{"issue":"5","key":"2021121018424260900_B8","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1542\/peds.2007-3770","article-title":"Prophylaxis after first febrile urinary tract infection in children? 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