Navigation Links
Drug pair cuts children's urinary infections up to 80 percent

Long-term use of a drug combination reduces the risk of recurrent urinary tract infection by up to 80 percent in children with the urinary condition vesicoureteral reflux compared to placebo, according to research funded by the National Institutes of Health. Results were published online May 4 in the New England Journal of Medicine to coincide with presentation at the Pediatric Academic Societies Annual Meeting in Vancouver, British Columbia.

In vesicoureteral reflux (VUR), developmental abnormalities in one or both ureters -- tubes connecting the kidneys with the bladder -- allow urine to flow back from the bladder into the ureters, and sometimes into the kidneys. VUR is found in 30-40 percent of children who have had a UTI, and is one of the most common urinary tract problems in children.

The risk of recurrent infection was cut by 50 percent in children with VUR using the drug combination trimethoprim/sulfamethoxazole (TMP/SMZ). Children with VUR and bladder and bowel dysfunction saw the greatest reduction, up to an 80 percent lower risk of recurrent infections. This group is also more likely to have recurrent urinary infections, which can increase the risk of kidney scarring and the potential for kidney failure.

For decades, doctors have treated children who have VUR with a small daily dose of TMP/SMZ often for years, in hopes of preventing recurrent UTIs and kidney damage. The Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial provides the first conclusive clinical evidence for the effectiveness of this practice. It studied a well-defined population of children compared to earlier studies, included a placebo group, used digital imaging, and showed a strong response to treatment.

"We are looking deeper into the data from the RIVUR trial to gain further insight into other factors that may reduce susceptibility to recurrent infections and scarring," said Dr. Marva Moxey-Mims, a pediatric kidney specialist at the NIH's National Institute of Diabetes and Digestive and Kidney Diseases, the study's primary funder. "In the meantime, we can buy children some time with fewer infections, allowing many of them to outgrow reflux as their bodies develop and mature."

While TMP/SMZ significantly reduced recurrent infections, the number of children who developed kidney scarring did not drop. The researchers suggest this may be due to parents' heightened vigilance for UTI symptoms and early treatment in the trial and that most of the children were enrolled after their first infection rather than after multiple infections, when more scarring might occur.

"We also saw some increased antimicrobial resistance, which researchers are looking at more closely," Moxey-Mims said. "However, until we have those results, the use of these drugs appears to provide more benefit than risk in these children."

RIVUR was a two-year clinical trial that randomized 607 children to receive the TMP/SMP drug combination or placebo. The study was conducted in 19 locations across the United States and coordinated by the University of North Carolina at Chapel Hill. General information about clinical studies in children can be found at


Contact: Bill Polglase
NIH/National Institute of Diabetes and Digestive and Kidney Diseases

Related medicine news :

1. CHOC researchers identify technique to reduce childrens post-op pain after high-risk surgery
2. Vibrant Nutraceuticals Announces Launch of Vegan Childrens’ Probiotic, KidsLac
3. Impact of battlefield-related genitourinary injuries described in Journal of Mens Health
4. Dance and virtual reality: A promising treatment for urinary incontinence in elderly women
5. LA BioMed study finds daily antibiotics most effective in preventing recurrent urinary tract infection
6. Urinary Tract Infection Market (UTI): Gram-Negative Bacterial 2022 Epidemiology Forecasts in New Research Report at
7. Minimally Invasive Urethral Sling Procedure Treats Urinary Incontinence; Consultations Now Available at Women’s Excellence's New Location Near Berkley, Michigan
8. Italian study examines clinical predictors of acute urinary symptoms after radiotherapy for prostate
9. New study: Enterocystoplasty in children with genitourinary abnormalities is safe and effective
10. Macrophage-derived mediators may have potential as biomarkers for urinary stone risk
11. J. William Groves, Jr. MD, FACOG, Receives InTone Specialist Certification to Treat Female Urinary Incontinence from InControl Medical, LLC
Post Your Comments:
Related Image:
Drug pair cuts children's urinary infections up to 80 percent
(Date:11/25/2015)... ... 2015 , ... Brillianteen, McGaw YMCA’s student-produced musical show, will ... Anniversary Brillianteen Revue, scheduled for March 4-6, 2016. Auditions for this final production ... been a treasured tradition for numerous families in the Evanston community. Over the ...
(Date:11/25/2015)... , ... November 25, 2015 , ... “While riding the ... inventor, from Bronx, N.Y. “I thought there had to be a convenient and comfortable ... PROTECTOR. , The PROTECTOR enables disabled individuals to safely travel during cold or inclement ...
(Date:11/25/2015)... , ... November 25, 2015 , ... ... provide scholarships for people struggling with eating disorders as a result of the ... second annual event, held at Fox Run Golf Club in Eureka, will help ...
(Date:11/25/2015)... ... 25, 2015 , ... "When I underwent breast reconstruction following ... uncomfortable," said an inventor from Bronx, N.Y. "In order to meet my own ... BRA for added comfort and support. The bra is easier to put on ...
(Date:11/25/2015)... ... ... An unlikely combination of recycled plastic shopping bags in ... to have a more dignified and comfortable night’s sleep. , Residents of Friendship ... bags into sleeping mats for the homeless. The project, according to Jeannette ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... 26, 2015 ... "2016 Future Horizons and Growth Strategies ... Market: Supplier Shares, Country Segment Forecasts, Competitive ... offering. --> ) has ... Future Horizons and Growth Strategies in the ...
(Date:11/26/2015)... 2015 ... the  "2016 Future Horizons and Growth ... Monitoring (TDM) Market: Supplier Shares, Country ...  report to their offering.  --> ... addition of the  "2016 Future Horizons ...
(Date:11/26/2015)... DUBLIN , Nov. 26, 2015 ... the addition of the "2016 Future Horizons ... Monitoring (TDM) Market: Supplier Shares, Country Segment Forecasts, ... offering. --> ... comprehensive analysis of the Italian therapeutic drug monitoring ...
Breaking Medicine Technology: