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Subject: Re: Antibiotics only treatment for reflux?
Forum: The Urology Forum
Topic Area: Pediatric Urology
Posted by Lisa on July 10, 1999 at 11:25:41My 2 month old daughter was diagnosed with Kidney reflux recently. She has grade 3 reflux in her right kidney and Grade 2 (borderline 3) in her left kidney. The current plan - she is on Keflex (125mg a day) for 6 months, urinalysis once a month initially, and at six months will get a repeat VCUG to see if the reflux is still occuring. If so, I gather we will repeat this six month routine until at some point they determine that it needs corrective surgery unless it corrects itself. I don't like the idea of her possibly being on antiobiotics for years - is this the only treatment option available? Is it possible to monitor her through more frequent urinalysis - say once a week? What are the effects of long term antiobiotic use? ANY info, advice, suggestions would be greatly appreciated.
Posted by HFHS M.D.-BE on July 14, 1999 at 16:42:31
=Dear Lisa,
The usual routine for treatment of newly diagnosed urinary reflux is long term prophylactic antibiotics.
There is a good chance that a grade 2 or 3 reflux would resolve over time without any need for corrective surgery. The patient, however, needs to be on antibiotics to prevent infection, since this( infection) could cause renal scarring, which in turn contributes to deterioration of renal function. Frequent urinalysis is not an optimal and safe way of detection of infection, which if missed for even a few days, could cause long term problems. As the child grows and follow-up evaluation reveals the resolution of reflux, it is possible to stop the antibiotics and hope that no more infections would result. If the patient develops breakthrough urinary infection while on antibiotics, or after antibiotics were discontinued, surgical repair may have to be considered. The option of restarting a different antibiotic is also a possibility.
As far as the long term effects of antibiotics, it is possible to develop: 1) resistant bacteria, 2) sesitivity and allergy to the antibiotic or3)have side effects from the antibiotic. These can be taken care of by switching to a different antibiotic. Otherwise, there should be no major concerns for taking long term antibiotics.
The alternative to prophylactic antibiotics would be corrective surgery, which has its own indications and set of risks.
It is the more conservative and prudent route to consider antibiotics as the starting course of action. This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its urban campuses by calling (1 800 653 6568). Sincerely;
HFHS-M.D. BE
* Keyword: vesicoureteral reflux
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