A pediatric patient with primary vesicoureteral reflux is often placed on prophylactic antibiotic therapy to prevent urinary tract infection. A number of factors may be associated with breakthrough infection in these patients. A patient with breakthrough infection may be a candidate for surgery.

Patient selection: primary vesicoureteral reflux


The key risk factor for breakthrough infection is an abnormal renal scan (using 99m technetium dimercaptosuccinic acid), especially in an infant.


Additional risk factors for breakthrough infection:

(1) poor antibiotic compliance

(2) resistant bacteria

(3) inappropriate antibiotic selection for the prophylactic antibiotic

(4) bilateral reflux

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