Antibiotics for performing voiding cystourethrogram: a randomised control trial

Sinha, Rajiv; Saha, Subhasis; Maji, Biplab; Tse, Yincent

doi:10.1136/archdischild-2017-313266

Cited by 13 publications

(14 citation statements)

References 21 publications

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“…In addition, the last method features urinary tract infection as a complication. 14 Here, we measured FBC using the 48-h F/V chart and UFM with PVR. There was no significant difference in the FBC values obtained from the two measurement methods.…”

Section: Discussionmentioning

confidence: 99%

<p>Evaluation of Functional Bladder Capacity in Children with Nocturnal Enuresis According to Type and Treatment Outcome</p>

Kang

Chung

2020

RRU

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This study aimed to identify whether functional bladder capacity (FBC) differs among subgroups of nocturnal enuresis (NE) patients and can be used to predict treatment response. Methods: A total of 69 children with NE were included in this study between July 2017 and February 2019 according to medical chart review, retrospectively. All patients completed a questionnaire about voiding symptoms and 48-hour frequency/volume (48-h F/V) charts. FBC was obtained from the 48-h F/V charts and uroflowmetry (UFM) with post-void residual volume (PVR). All patients were primarily treated with standard urotherapy and pharmacological therapy. The response rate was analyzed at 3 months after treatment. Results: The mean age of the 69 patients (42 male, 27 female) was 83.3 ± 22.4 months (range, 5-13 years) at the first visit. The percentages of children with monosymptomatic NE (MNE) and non-monosymptomatic NE (NMNE) on the questionnaire were 40.6% (28/69) and 59.4% (41/69), respectively. FBC of all patients was lower than the normal range of expected bladder capacity, and there were no significant differences between measurement methods, NE types (MNE vs NMNE), or response rates (p > 0.05). Conclusion: Children with NE had diminished FBC in both 48-h F/V charts and UFM with PVR. We found no difference in FBC by NE type or treatment outcome. Therefore, FBC cannot be used to distinguish between NE types or predict treatment responses.

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Section: Discussionmentioning

confidence: 99%

<p>Evaluation of Functional Bladder Capacity in Children with Nocturnal Enuresis According to Type and Treatment Outcome</p>

Kang

Chung

2020

RRU

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“…In children undergoing RUG or UDS, ppUTI was documented in 2.1% and 0-4.8% of cases, respectively. Larger variations were evidenced in studies enrolling children with VCUG and RNC, among whom ppUTI was diagnosed in up to 42% of children [14][15][16][17][18][19][20]. The highest values were reported in the oldest studies, while in the most recent evaluations incidence rates of ppUTI were found in the range already reported for the other imaging procedures with catheterization.…”

Section: Scenario #1 Imaging Procedures Involving the Urinary Tractmentioning

confidence: 98%

“…However, studies carried out in children undergoing imaging procedures requiring catheterization have shown that the risk of ppUTI is generally low, although with some exceptions [14][15][16][17][18][19][20]. In children undergoing RUG or UDS, ppUTI was documented in 2.1% and 0-4.8% of cases, respectively.…”

Section: Scenario #1 Imaging Procedures Involving the Urinary Tractmentioning

confidence: 99%

“…However, administration of antibiotics does not exclude ppUTI development, at least in children with urologic abnormalities. Sinha et al treated children undergoing VCUG with antibiotics (cephalexin if <6 months or trimethoprim/sulfamethoxazole if >6 months old) because of various urological problems and reported that children with an abnormal preprocedure renal ultrasound were at increased risk of ppUTI (odds ratio [OR] 9.51, 95% confidence interval [CI] 1.43 to 63.4) [19]. Although available evidence does not allow us to draw firm conclusions on the risk of ppUTI after one-time urinary catheterization procedures and the efficacy of antibiotic prophylaxis, it may be suggested that antibiotics might be given to children with strongly suspected or already proven urinary abnormalities when they undergo RUG, UDS, VCUG, and RNC.…”

Section: Scenario #1 Imaging Procedures Involving the Urinary Tractmentioning

confidence: 99%

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Antimicrobial Prophylaxis for Urologic Procedures in Paediatric Patients: A RAND/UCLA Appropriateness Method Consensus Study in Italy

et al. 2022

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The main aim of surgical antimicrobial prophylaxis (SAP) in urologic procedures is to prevent bacteraemia, surgical site infections (SSIs), and postoperative urinary tract infections (ppUTIs). Guidelines for SAP in paediatric urology are lacking. Only some aspects of this complex topic have been studied, and the use of antibiotic prophylaxis prior to surgical procedures seems to be more often linked to institutional schools of thought or experts’ opinions than to rules dictated by studies demonstrating the most correct and preferred management. Therefore, the aim of this Consensus document realized using the RAND/UCLA appropriateness method is to provide clinicians with a series of recommendations on SAP for the prevention of bacteraemia, SSIs, and ppUTIs after urologic imaging and surgical procedures in paediatric patients. Despite the few available studies, experts agree on some basilar concepts related to SAP for urologic procedures in paediatric patients. Before any urological procedure is conducted, UTI must be excluded. Clean procedures do not require SAP, with the exception of prosthetic device implantation and groin and perineal incisions where the SSI risk may be increased. In contrast, SAP is needed in clean-contaminated procedures. Studies have also suggested the safety of eliminating SAP in paediatric hernia repair and orchiopexy. To limit the emergence of resistance, every effort to reduce and rationalize antibiotic consumption for SAP must be made. Increased use of antibiotic stewardship can be greatly effective in this regard.

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“…Based on a randomized controlled trial on preventing VCUGrelated UTI, it is recommended to use antibiotics post-VCUG in patients with abnormal USG findings. 44 A 1% risk of post-VCUG UTI was reported for children with congenital urological anomalies, such as VUR or hydronephrosis. Particular care needs to be taken with VUR and/or hydronephrosis patients when carrying out VCUG.…”

Section: Complications Of Vcugmentioning

confidence: 99%

Pediatric voiding cystourethrography: An essential examination for urologists but a terrible experience for children

et al. 2018

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Voiding cystourethrography is the most important fluoroscopic examination in pediatric urology for the investigation of lower urogenital tract diseases, such as vesicoureteral reflux or urethral stricture. However, this invasive procedure imposes a significant burden on children and their parents, and recently there has been a paradigm shift in the diagnosis and treatment of vesicoureteral reflux. In the 2011 revision, the American Academy of Pediatrics guidelines on urinary tract infection recommended abandoning routine voiding cystourethrography after the first febrile urinary tract infection. In 2014, the randomized intervention for children with vesicoureteral reflux study recommended discontinuation of routine continuous antibiotic prophylaxis for vesicoureteral reflux. The time is now ripe to radically reconsider indications for voiding cystourethrography and the procedure itself.

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Antibiotics for performing voiding cystourethrogram: a randomised control trial

Abstract: Clinical Trial Registry of India: CTRI/2017/03/00824.

Cited by 13 publications

References 21 publications

<p>Evaluation of Functional Bladder Capacity in Children with Nocturnal Enuresis According to Type and Treatment Outcome</p>

<p>Evaluation of Functional Bladder Capacity in Children with Nocturnal Enuresis According to Type and Treatment Outcome</p>

Antimicrobial Prophylaxis for Urologic Procedures in Paediatric Patients: A RAND/UCLA Appropriateness Method Consensus Study in Italy

Pediatric voiding cystourethrography: An essential examination for urologists but a terrible experience for children

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