Clinical Outcomes of Voiding Cystourethrogram and Antibiotic Prophylaxis.

Abstract

Background Urinary tract infections (UTIs) are a prevalent and potentially serious bacterial infection observed among children. Presently, the primary use of diagnostic imaging for UTI is to pinpoint young patients who are at a high risk of developing renal scarring. The most significant procedure for pediatricurology fluoroscopic evaluation is voiding cystourethrogram (VCUG). VCUG-acquired UTIs continue to be an important concern and the purpose of this study is to assess the clinical outcomes of antibiotic prophylaxis on VCUG-associated UTIs. Methods This retrospective study included all patients who underwent VCUG procedures performed from the year 2014 to 2021. All data were retrieved from the medical registries and databases. Radiological and laboratory investigations related to the VCUG procedures were thoroughly reviewed. Patients were considered to have post-procedure UTI if urological symptoms including fever and dysuria along with positive urine culture were exhibited within four weeks after the VCUG study. Patients with incomplete medical records were excluded from the analysis. Results This study consisted of 147 participants. Continuous antibiotic prophylaxis (CAP) was observed in 57 (38.8%) participants of them 35 (23.8%) participants suffered from UTI while urine culture and sensitivity testing were performed among 142 (96.6%) participants before VCUG which came negative and only five (3.4%) had a positive result. Overall, the results of the Chi-square test of association revealed a significant association between sex and vesicoureteral reflux (VUR), indicating that the prevalence of VUR differs between males and females. However, no significant associations were observed between VUR and UTI, urine culture and sensitivity results, hydronephrosis, type of catheter, or choice of antibiotic. Conclusion In conclusion, this study contributes valuable insights into the clinical outcomes of antibiotic prophylaxis on VCUG-associated UTIs. Despite the prophylaxis rate of 38.8%, UTIs were still observed in a significant proportion of children undergoing VCUG. This calls for further research to identify additional risk factors, optimize prophylaxis strategies, and enhance the overall safety and efficacy of VCUG procedures in children.