Christina B Ching1. 1. Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. Christina.ching@nationwidechildrens.org.
Abstract
PURPOSE OF REVIEW: While antibiotics have been a staple in the management and even prevention of urinary tract infections (UTIs), it is not without significant consequences due to intolerance and development of antibiotic resistant bacteria. These concerns necessitate alternatives to antibiotic use in the management of pediatric UTIs. This review seeks to evaluate non-antibiotic means of preventing UTI in the pediatric population. RECENT FINDINGS: The search for preventative alternatives to antibiotics has included D-mannose, cranberry, and probiotics. These products similarly work through competitive inhibition of uropathogens in the urinary tract. Pediatric studies exist highlighting the use of cranberry extract/juice and probiotics in UTI prevention, although significant heterogeneity amongst studies have limited overarching recommendations for their use. Data of D-mannose use is extrapolated from adult literature. More studies are required in the utility of each treatment, with some emphasis on larger sample sizes and clarifications regarding dosing and formulation.
PURPOSE OF REVIEW: While antibiotics have been a staple in the management and even prevention of urinary tract infections (UTIs), it is not without significant consequences due to intolerance and development of antibiotic resistant bacteria. These concerns necessitate alternatives to antibiotic use in the management of pediatric UTIs. This review seeks to evaluate non-antibiotic means of preventing UTI in the pediatric population. RECENT FINDINGS: The search for preventative alternatives to antibiotics has included D-mannose, cranberry, and probiotics. These products similarly work through competitive inhibition of uropathogens in the urinary tract. Pediatric studies exist highlighting the use of cranberry extract/juice and probiotics in UTI prevention, although significant heterogeneity amongst studies have limited overarching recommendations for their use. Data of D-mannose use is extrapolated from adult literature. More studies are required in the utility of each treatment, with some emphasis on larger sample sizes and clarifications regarding dosing and formulation.
Authors: Jonathan C Craig; Judy M Simpson; Gabrielle J Williams; Alison Lowe; Graham J Reynolds; Steven J McTaggart; Elisabeth M Hodson; Jonathan R Carapetis; Noel E Cranswick; Grahame Smith; Les M Irwig; Patrina H Y Caldwell; Sana Hamilton; Leslie P Roy Journal: N Engl J Med Date: 2009-10-29 Impact factor: 91.245
Authors: Patrick H Conway; Avital Cnaan; Theoklis Zaoutis; Brandon V Henry; Robert W Grundmeier; Ron Keren Journal: JAMA Date: 2007-07-11 Impact factor: 56.272