Table 1

Characteristics of trials of interventions for children with vesicoureteric reflux

Study	Country	No. enrolled/no. evaluated	Participants	Inclusion criteria	Intervention	Duration of antibiotics	Outcomes
*Grade of reflux standardised to the International Reflux Study. †On intravenous pyelogram. ‡Glomerular filtration rate. §On renal ultrasound.
¶On 99m-technetium dimercaptosuccinic acid scan.
PL, Politano-Leadbetter procedure; LG, Lich-Gregoir procedure; Dx/HA copolymer, dextranomer/hyaluronic acid copolymer.
Holland (1982)²⁰	USA	10/10	Children 2 months – 10 years (mean 4.75 years)	Reflux grade* II–IV, with normal renal function and blood pressure	Antibiotic: trimethoprim-sulphamethoxazole or nitrofurantoin 1 mg/kg	Both groups: 5 month – 36 months (mean 17 months)	UTI – culture positive Renal damage† Adverse effects of antibiotics
			Source: not stated		Combined: reimplantation (not specified) and antibiotics
BRS (1987)^21–²³	UK	179/161	Children <15 years	Reflux grade II with scarring or grade III, IV, V in absence of UTI within last 12 months	Antibiotic: trimethoprim or nitrofurantoin 1–2 mg/kg	Antibiotic: 2 year if resolution of reflux or 5 years	UTI – culture positive Renal damage† GFR‡ Resolution of reflux Renal length
			Source: GP, paediatrician referrals, hospital casualty		Combined: PL or Cohen reimplantation and antibiotics	Combined: 2 years
Morris (1991)¹⁹	New Zealand	138/118	Children 6 months – 10 years	Reflux grade III–IV, no major urological abnormality	Antibiotic: type and dose not stated	Antibiotic: 2 years	UTI – culture positive GFR Resolution of reflux
			Source: not stated		Combined: Cohen reimplantation and antibiotics	Combined: 3 months
IRS Europe (1992)¹⁵^24–³²	Europe	321/302	Children 6 days – 11 years	Reflux grade III or IV, no major urinary tract abnormality, no previous urinary tract surgery, creatinine normal	Antibiotic: nitrofurantoin or trimethoprim 1–2 mg/kg	Antibiotic: resolution of reflux or 5 years	UTI – culture positive Renal damage† Obstruction post-op Resolution of reflux Renal length
			Source: university teaching hospitals		Combined: PL, Cohen, LG reimplantation and antibiotics	Combined: 6 months
IRS US (1992)^33–³⁵	USA	142/132	Children <10 years	Reflux grade III or IV, no major urinary tract abnormality, no previous urinary tract surgery, creatinine normal	Antibiotic: nitrofurantoin or trimethoprim 1–2 mg/kg	Antibiotic: resolution of reflux or 5 years	UTI – culture positive Renal damage† Resolution of reflux Renal area
			Source: university teaching hospitals		Combined: PL, Cohen, or other reimplantation and antibiotics	Combined: 6 months
Reddy (1997)¹⁸	USA	43/29	Children: age range not stated	Reflux grade not stated, newly diagnosed	Antibiotic prophylaxis: antibiotic not specified	Antibiotic: 1 year	UTI Renal damage¶ Resolution of reflux
			Source: university teaching hospital		No treatment: daily urine nitrate
					Intermittent antibiotics 3 times per wk
Smellie (2001)³⁶	UK	53/50	Children 1–12 years	Reflux grade III–V with bilateral abnormal IVP, no major urological abnormality	Antibiotic: nitrofurantoin or trimethoprim or trimethoprim-sulphamethoxazole 1–2 mg/kg	Antibiotic: variable	UTI – culture positive Renal damage† GFR (change) Renal length (change)
			Source: university teaching hospital		Combined: Cohen and antibiotics	Combined: 6 months
Capozza (2002)⁵	Italy	61/60	Children > 1 year	Reflux grade II–IV for ≥6 mth, no major urological abnormality, no recurrent UTI	Antibiotic: Not specified	Antibiotic: 1 year	UTI Renal damage§¶ GFR (change) Resolution of reflux
			Source: university teaching hospital		Combined: Dx/HA copolymer implantation and antibiotics	Combined: 1 month