Whether or not to give antibiotic prophylaxis to children known to have vesico-ureteric reflux (VUR) remains highly controversial. In 2007, the UK National Institute for Health and Clinical Excellence (NICE) came out against its routine use, and since then many authorities have questioned this advice, some using the pages of this journal. The evidence from published trials is contradictory and confusing. Now a new multicentre randomised controlled trial (RCT) from the US makes an important contribution to the debate (The RIVUR Trial. NEJM 2014;370:2367–76). Over 600 children (92% girls) …