Study designs of evaluations included in the review
Only randomised controlled trials (RCTs) were included in the review.
Specific interventions included in the review
Studies were included if they examined any type of antibiotic therapy for the purpose of preventing UTI, and were administered for a minimum of 3 months. Studies that included surgery of the urinary tract were excluded. The interventions evaluated in included studies were nitrofurantoin (3,5 and 6 months), co-trimoxazole (10 months), and sulfisoxazole (duration unclear). The control groups were placebo, no treatment, and OM-89 (Uro-VaxomR).
Participants included in the review
The inclusion criteria for the review specified study populations of children up to 18 years of age who had a history of recurrent UTI or who had had one symptomatic infection. Studies of covert asymptomatic bacteriuria were excluded. Studies of patients whose urinary tract abnormality could not be characterised were excluded.
The review included three studies of children with normal urinary tract, and three of children with neurogenic bladder.
Outcomes assessed in the review
The outcome of interest was the number of UTIs in children who received antibiotic prophylaxis, compared with the number of such infections in those who received a placebo, no treatment, or non-antibiotic treatment.
The criteria for UTI used in the included studies varied. They encompassed studies that required clinical symptoms only, as well as studies requiring a positive culture in addition to clinical symptoms.
How were decisions on the relevance of primary studies made?
One author screened the abstracts and excluded reviews, trials involving adults, and trials dealing with the prolonged treatment of acute infection. Potentially relevant publications were then retrieved. Two authors screened these for inclusion in the review, using a standard relevance form based on the inclusion criteria. Any disagreements were resolved by consensus.