Randomised controlled trials (RCTs) that compared prophylactic antibiotic use in children at risk of developing urinary tract infections (UTI), as defined by the authors, were eligible for inclusion. The population was defined as children (aged up to 18 years) who previously had a UTI with or without vesicoureteric reflux (VUR) or children who had been diagnosed with VUR in the absence of a UTI. Control groups could be placebo, no therapy or other non-antibiotic non-surgical prophylactic treatment. Outcomes were defined as incidence of new or progressive renal scarring, recurrences of pyelonephritis, incidence of symptomatic UTI or prevalence of bacteriuria. Children with pre-existing uropathies, underlying renal conditions, who received antibiotics or who were immunosuppressed were excluded.
Ages of children included in the trials ranged from one month to 17 years. Most participants were female. For trials that compared active prophylaxis with placebo or no treatment, follow-up ranged from six months to four years. Antibiotics used were co-trimoxazole, co-amoxiclav, sulphamethoxazole/trimethoprim and nitrofurantoin. Population categories were children who had symptomatic UTI without VUR and children who had symptomatic UTI with/without VUR.
Studies were selected by two independent reviewers. Disagreements were resolved by discussion with other reviewers.