Michael Goodwin*
The Greek word prophylaxis means "to guard or prevent beforehand." In Pediatric Urology, antibiotic prophylaxis is the attempt to prevent urinary tract infections (UTIs) in children who are predisposed to them, such as those with vesicoureteral reflux (VUR) and hydroureteronephrosis. Antibiotic prophylaxis for paediatric urologic conditions has both demonstrated benefit and demonstrated harm. Antibiotic prophylaxis for all children with VUR, as well as those with all grades of hydronephrosis (HN) and hydroureteronephrosis, is at best unnecessary and at worst harmful. The full impact of prophylactic antibiotics on the developing and ageing body, for better or worse is unknown. Over the last two decades, increased public and physician awareness of the truth of previous statements has resulted in a more selective approach to the use of prophylactic antibiotics. Although it was previously thought that most children with conditions such as VUR or hydronephrosis were at high risk of UTI and thus would benefit from continuous antibiotic prophylaxis (CAP), data from multiple studies has shown otherwise.
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