Use of Probiotics for Prophylaxis of Urinary Tract Infection Recurrence in Children; A Randomized Controlled Trial

Abstract

Introduction; Urinary tract infection (UTI) is a prevalent bacterial infection which can cause many complications such as cystitis, abscess formation, fistula, bacteremia, sepsis, pyelonephritis and kidney dysfunction if not treated appropriately. Probiotics have been proposed to be used as an alternative option to prevent recurrence of urinary tract infection with controversial results. Therefore, we decided to examine the potential of probiotics to prevent recurrence of urinary tract infection in children.

Methods and Materials; This was a randomized controlled trial. Ninety-four children (1 to 12 years old) were randomly divided into two groups of probiotics and placebo. All patients received a routine antibiotic regimen for UTI. Children in the probiotics group also received a probiotic and the placebo group received a placebo after antibiotic therapy. Children were followed up for six months for UTI recurrence. Regression was used to analyze the effect of probiotics for recurrent UTI. Data entered SPSS and analyzed.

Results; Ninety-four children entered the study, 47 in each group. The mean age of children in the probiotic and placebo groups were 4.7 ± 2.56 and 3.4 ± 2.34 years, respectively. There were statistically significant differences between the two groups regarding age (P value = 0.009) and body weight (P value = 0.018). In total, 39 of 47 patients (83%) in the placebo group and 44 of 47 patients (93.6%) in the probiotic group did not experience a recurrence. A logistic regression was performed to investigate the relationship between probiotic use and recurrence with the control of age and weight variables. The results showed that probiotics use had a significant preventive effect on disease recurrence (P value= 0.04). The probability of recurrence in patients who did not receive probiotics was more than five times higher than those who received it.

Discussion; Probiotic use was effective to reduce the probability of UTI recurrence in children. However, more studies with combination of probiotics and antibiotics are recommended to yield clearer results regarding probiotics prophylactic effect in urinary tract infection.