Could prophylactic antibiotics be stopped in patients with history of vesicoureteral reflux

Abstract Objective To compare the incidence and type of urinary tract infection (UTI) in patients with primary vesicoureteral reflux (VUR) diagnosed after a febrile UTI while they were on prophylactic antibiotics (PA) and after stopping PA. Materials and methods Criteria to discontinue PA were: no UTI during 12+ or more months on PA, old enough to communicate UTI symptoms, potty trained and absence of risk factors for UTI. Patients with at least 1 year of follow up without PA were included ( n  = 77). We recorded: age at which PA was indicated and stopped, time on and off PA, incidence and type of UTI (cystitis vs acute pyelonephritis (APN)), and renal scan results. Results PA was started and stopped at a mean age of 18.5 and 61 months, respectively. Mean time on PA was 39 months (range 12–95): 25 patients had 44 UTI episodes (0.17 episodes/patient/year), and 31 (70%) of them were APN. Mean time of antibiotics was 44.5 months (range 12–162): 13 patients had 24 UTI episodes (0.08 episodes/patient/year), eight (33%) of which were APN ( P Conclusion Discontinuing PA in patients with history of VUR is a safe practice and should be considered as a management option.