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Timing of voiding cystourethrography after febrile urinary tract infection in children: a systematic review
  1. Sara Mazzi1,
  2. Katharina Rohner2,
  3. Wesley Hayes3,4,
  4. Marcus Weitz5
  1. 1 Paediatrics, University Children's Hospital Zurich, Zurich, Switzerland
  2. 2 Pediatric Nephrology, University Children's Hospital Zurich, Zurich, Switzerland
  3. 3 Nephrology, Great Ormond Street Hospital for Children NHS Trust, London, UK
  4. 4 University College London Centre for Nephrology, London, UK
  5. 5 Nephrology, University Children's Hospital Zurich, Zurich, Switzerland
  1. Correspondence to Dr Marcus Weitz, Nephrology, University Children's Hospital Zurich, Zurich 8032, Switzerland; marcus.weitz{at}kispi.uzh.ch

Abstract

Background Despite a trend towards early voiding cystourethrography (VCUG) after febrile urinary tract infection (fUTI) in children, clinical guidelines do not comment on the optimal timing and current practice varies considerably.

Objective To assess whether the detection rate of vesicoureteric reflux (VUR) in children depends on the time period of VCUG procedure after onset of antibiotic therapy.

Methods MEDLINE, EMBASE and Cochrane Controlled Trials Register electronic databases were searched for eligible studies without language or time restriction (19 November 2018). Inclusion criteria were (1) patients <18 years of age; (2) VCUG performed in patients with fUTI after onset of antibiotic therapy either in the same patient population or in two or more different patient populations within one study at different time periods; and (3) with reported detection rate of VUR. The systematic review was carried out following the recommendations of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Results Of 4175 records, nine studies were included (number of patients, n=1745) for the main outcome prevalence of VUR by VCUG <8 days compared with VCUG ≥8 days after onset of antibiotic therapy. Pooled overall prevalence of VUR was not significantly different between the early and the late VCUG groups (risk ratio 0.98, 95% CI 0.81 to 1.19). Prevalence of VUR stratified by grade was not significantly different between the two groups.

Conclusion Early VCUG within 8 days after onset of antibiotic therapy does not affect the prevalence of VUR.

Trial registration number CRD42018117545

  • timing voiding cystourethrography
  • urinary tract infection
  • vesicoureteric reflux
  • children
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Footnotes

  • Correction notice The article type has been changed to Original article since this paper was published Online First.

  • Contributors Research idea and study design: MW. Data acquisition: SM, KR, MW. Data analysis/interpretation: SM, MW. Statistical analysis: MW. Writing of the manuscript: SM, MW, WH. Each author contributed important intellectual content during manuscript drafting or revision and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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