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Randomised controlled trial
RIVUR trial offers confirmatory evidence for a small but real benefit of antibiotics for UTI prevention in children
  1. Gabrielle Williams1,2,
  2. Jonathan Craig2
  1. 1The Children's Hospital at Westmead, Sydney, New South Wales, Australia
  2. 2School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to; Dr Gabrielle Williams, School of Public Health, University of Sydney, Edward Ford Building, Camperdown, Sydney, NSW 2006, Australia; gabrielle.williams{at}sydney.edu.au

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Context

Urinary tract infections (UTIs) are common in children and can cause considerable morbidity; furthermore, UTIs recur in 10–20% of patients.1–3 Some literature claims there are serious adverse long-term consequences of UTIs, such as hypertension and end-stage kidney disease, but evidence is sparse and lacks denominators.4 ,5 Numerous trials of low-dose antibiotics for recurrent UTIs have been published and six systematic reviews have synthesised these data. Early trials were small and poorly designed and focussed on select groups of children, making them relatively uninformative for clinical guidance. The power and statistical precision of better-designed later trials was limited by small study size. In 2009 the largest trial then published—placebo-controlled and assessing a broad range …

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