We examined the preventive effect of probiotic and antibiotics versus antibiotics alone, in children
with recurrent urinary tract infections (RUTI) in a preliminary randomized clinical trial.
Between March 2007 and April 2011, children with the history of RUTI and unilateral
vesicoureteral reflux (VUR) were randomly assigned to receive concomitant probiotic and antibiotics
( Lactobacillus acidophilus
and bifidobacterium lactis
/ml, as 0.25 ml/kg three times a day regimen in
addition to Nitrofurantoin, 1mg/kg daily (group I). In group II, all children received conventional prophylactic
antibiotics alone (Nitrofurantoin, 1 mg/kg daily). Randomization was performed via using the random
numerals table in a 1:1 manner with stratification by sex, age and grade of reflux. The urine examinations
were done monthly and the incidence of UTI was evaluated in these two groups.
Forty-one children (age: 8.3±3.1 years) in group I and 44 children (age: 8.0±3.0 years) in group II
were compared. During the course of three years, 39% in group I and 50% of participants in group II
experienced RUTIs (P
=0.4). Incidences of UTI - febrile and afebrile - reduced in both groups without any
significant differences after two years of prophylaxis. Also, incidence of afebrile UTIs did not significantly
differ (0.51±1.30 and 0.81±1.41 respectively, P
=0.3); however, the incidence of febrile UTIs in particular were
lower in group I (0.00±0.00 versus 0.13±0.40, P
=0.03) in the last year.
The consumption of probiotic and antibiotics in children with RUTI is safe and more effective in
reducing the incidence of febrile UTI in comparison to prophylactic antibiotics alone.