Role of antibiotic prophylaxis in antenatal hydronephrosis: A systematic review from the European Association of Urology/European Society for Paediatric Urology Guidelines Panel
Abstract
The review aims to compare benefits and harms of continuous antibiotic prophylaxis (CAP) with observation in patients with antenatal hydronephrosis. The search was performed in databases - Medline, Embase, Cochrane - since 1980 and the studies were critically evaluated using Revman software.
The outcomes included reduction in urinary tract infection (UTI), drug related adverse events and kidney function. 57 from 797 articles and six abstracts were eligible for inclusion. The benefit of CAP in a heterogeneous group of children with antenatal hydronephrosis involving different etiologies remains unproven.
No conclusion could be drawn for drug-related adverse events and kidney function. However, the evidence from the prospective and retrospective studies has shown that CAP reduces febrile UTI in particular subgroups: non-circumcised children, children with ureteral dilatation and with high-grade hydronephrosis.