This result stems from a randomized controlled trial led by the Institute of Child Health Burlo Garofolo (ICHBG) in Trieste (Italy) that lasted 6 years (2 years of investigation and 4 years of follow-up).
This study put an end to a long-lasting debate on the effectiveness of antibiotic prophylaxis in preventing the recurrences of urinary tract infections. The study, performed in 6 Paediatrics Hospitals in Northern Italy (Pordenone, Monfalcone, San Daniele, Tolmezzo, Cesena and Bologna), was published in the journal Pediatrics.
Vesicoureteral reflux is quite a common congenital anomaly in infancy. It is caused by the delay in the vesico-ureteral junction maturation that causes urine to flow towards the kidneys. This event may promote the onset of urinary tract infections that might be complicated by pyelonephritis, a severe and often recurrent renal inflammation. The disease usually resolves by the age of 10-12 years even in more severe cases, but in the meantime recurrent episodes of pyelonephritis may damage the renal function and lead to chronic renal failure.
Despite the lack of evidence about a causative relationship between VUR and recurrent pyelonephritis, the common clinical approach to vesicoureteral reflux was based on the use of long (many years) and continuous antibiotic prophylaxis even in asymptomatic children. It was commonly thought that this treatment could avoid renal involvement.
The multicentric study coordinated by the Institute of Child Health Burlo Garofolo in Trieste proves the ineffectiveness of this strategy and confirms the hypothesis that the better way to treat pyelonephritis in children with VUR is an early diagnosis followed by a single cycle of a specific antibiotic.
As Marco Pennesi, head of the Nephrology Unit of the Pediatric Department of ICHBG, says: “This trial puts two head points in the treatment of pyelonephritis in children with VUR. First of all, it shows that antibiotic prophylaxis is unhelpful in preventing acute recurrent renal inflammation; second of all, it study confirms that the standard approach (antibiotic prophylaxis) does not modify the natural history of the disease as it doesn’t significantly lower the incidence of renal damage evidenced by the presence of renal scars. Moreover, in contrast to other investigations that examined very heterogeneous populations (infants aged six months to boys of 18 years), this trial clearly spots the class of age at higher risk for complications, the one that really needs an early intervention: children under 30 months of age”
The trial enrolled 100 children under 30 months of age affected by proved VUR, who were randomized to be treated or not with the antibiotic prophylaxis. At the end of the study, the researchers didn’t find any significant difference between the two groups in terms of pyelonephritis or presence of more renal scars.
“Data collected in these 6 years – states Alessandro Ventura, Director of the Pediatric Clinic of the University of Trieste, located at the ICHBG – show that VUR by itself is not a risk factor for recurrent pyelonephritis as previously thought. Now it is of critical importance to add this new piece of evidence to the paediatric guidelines and to make Paediatricians aware of these new findings”.
Cristina Serra | alfa
Drone vs. truck deliveries: Which create less carbon pollution?
31.05.2017 | University of Washington
New study: How does Europe become a leading player for software and IT services?
03.04.2017 | Fraunhofer-Institut für System- und Innovationsforschung (ISI)
Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.
Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...
Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.
As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...
Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.
With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...
Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine
Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...
Germany counts high-precision manufacturing processes among its advantages as a location. It’s not just the aerospace and automotive industries that require almost waste-free, high-precision manufacturing to provide an efficient way of testing the shape and orientation tolerances of products. Since current inline measurement technology not yet provides the required accuracy, the Fraunhofer Institute for Laser Technology ILT is collaborating with four renowned industry partners in the INSPIRE project to develop inline sensors with a new accuracy class. Funded by the German Federal Ministry of Education and Research (BMBF), the project is scheduled to run until the end of 2019.
New Manufacturing Technologies for New Products
19.06.2017 | Event News
13.06.2017 | Event News
13.06.2017 | Event News
22.06.2017 | Materials Sciences
22.06.2017 | Information Technology
22.06.2017 | Medical Engineering