Utilidad del extracto de arándano rojo americano vs profilaxis antibiótica con trimetoprima en la prevención de la infección urinaria recurrente infantil

Resumen

ABSTRACT USEFULNESS OF AMERICAN CRANBERRY SYRUP VS ANTIBIOTIC PROPHYLAXIS WITH TRIMETHOPRIM IN THE PREVENTION OF RECURRENT URINARY TRACT INFECTION CHILDREN Doctoral program in clinical medicine and public health PhD student: Verónica Isabel Fernández Puentes Thesis Director: José Uberos Fernández Justification: Prophylaxis of recurrent urinary tract infection with trimethoprim in child has effectively shown both to reduce the recurrence of urinary tract infections and the frequency of multiresistant germs. As an alternative to antibiotic prophylaxis in this study raises evaluate the effectiveness of cranberry syrup in infant prophylaxis of recurrent urinary tract infection. Methods. Controlled, double-blind in children over 1 month of age develops clinical trial. It is assumed equivalence of a single evening dose of syrup cranberry vs trimethoprim for prophylaxis of urinary tract infection in children with a history of recurrent infections, vesicoureteral reflux or ectasia of renal pelvis associated with infection. Monitoring of patients is carried out for a maximum period of 1 year. The effect as recurrent urinary tract infection diagnosed by urine culture more pathological urine sediment is evaluated. Statistical analysis was performed using Kaplan Meier analysis. Results. Of 201 eligible patients, 192 were randomized in permuted blocks of 10 subjects for American or trimethoprim syrup blueberry. 75 patients were assigned to receive cranberry and 117 patients to receive trimethoprim. Patients on prophylaxis with cranberry syrup have recurrent urinary tract infection in 28% of patients (95% CI 11.0-45.8) versus 43% of those receiving trimethoprim (95% CI 26.9-64.6), these differences not statistically significant (95% CI 15 dif: -5.3 to 34.9). We observed no significant differences between patients with ectasia prophylaxis in renal pelvis and infection or vesicoureteral reflux. We observed a significant reduction in the hazard ratio ( eb = 0.33) of urinary tract infections in patients aged 1-3 when receiving cranberry syrup. Conclusions. Our study confirms that in the prophylaxis of recurrent urinary tract infection cranberry syrup is safe and effective in children, being effective for this indication not less than trimethoprim. (European Clinical Trials Registry EUDRACT 2007-004397-62). Keywords: American Blueberry; Urinary tract infection; Trimethoprim; Vesicoureteral reflux; Antibiotics; Prophylaxis