Table 1

Characteristics of trials of interventions for children with vesicoureteric reflux

StudyCountryNo. enrolled/no. evaluatedParticipantsInclusion criteriaInterventionDuration of antibioticsOutcomes
*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)20USA10/10Children 2 months – 10 years (mean 4.75 years)Reflux grade* II–IV, with normal renal function and blood pressureAntibiotic: trimethoprim-sulphamethoxazole or nitrofurantoin 1 mg/kgBoth groups: 5 month – 36 months (mean 17 months)
  • UTI – culture positive

  • Renal damage†

  • Adverse effects of antibiotics

Source: not statedCombined: reimplantation (not specified) and antibiotics
BRS (1987)21–23UK179/161Children <15 yearsReflux grade II with scarring or grade III, IV, V in absence of UTI within last 12 monthsAntibiotic: trimethoprim or nitrofurantoin 1–2 mg/kgAntibiotic: 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 casualtyCombined: PL or Cohen reimplantation and antibioticsCombined: 2 years
Morris (1991)19New Zealand138/118Children 6 months – 10 yearsReflux grade III–IV, no major urological abnormalityAntibiotic: type and dose not statedAntibiotic: 2 years
  • UTI – culture positive

  • GFR

  • Resolution of reflux

Source: not statedCombined: Cohen reimplantation and antibioticsCombined: 3 months
IRS Europe (1992)1524–32Europe321/302Children 6 days – 11 yearsReflux grade III or IV, no major urinary tract abnormality, no previous urinary tract surgery, creatinine normalAntibiotic: nitrofurantoin or trimethoprim 1–2 mg/kgAntibiotic: resolution of reflux or 5 years
  • UTI – culture positive

  • Renal damage†

  • Obstruction post-op

  • Resolution of reflux

  • Renal length

Source: university teaching hospitalsCombined: PL, Cohen, LG reimplantation and antibioticsCombined: 6 months
IRS US (1992)33–35USA142/132Children <10 yearsReflux grade III or IV, no major urinary tract abnormality, no previous urinary tract surgery, creatinine normalAntibiotic: nitrofurantoin or trimethoprim 1–2 mg/kgAntibiotic: resolution of reflux or 5 years
  • UTI – culture positive

  • Renal damage†

  • Resolution of reflux

  • Renal area

Source: university teaching hospitalsCombined: PL, Cohen, or other reimplantation and antibioticsCombined: 6 months
Reddy (1997)18USA43/29Children: age range not statedReflux grade not stated, newly diagnosedAntibiotic prophylaxis: antibiotic not specifiedAntibiotic: 1 year
  • UTI

  • Renal damage¶

  • Resolution of reflux

Source: university teaching hospitalNo treatment: daily urine nitrate
Intermittent antibiotics 3 times per wk
Smellie (2001)36UK53/50Children 1–12 yearsReflux grade III–V with bilateral abnormal IVP, no major urological abnormalityAntibiotic: nitrofurantoin or trimethoprim or trimethoprim-sulphamethoxazole 1–2 mg/kgAntibiotic: variable
  • UTI – culture positive

  • Renal damage†

  • GFR (change)

  • Renal length (change)

Source: university teaching hospitalCombined: Cohen and antibioticsCombined: 6 months
Capozza (2002)5Italy61/60Children > 1 yearReflux grade II–IV for ≥6 mth, no major urological abnormality, no recurrent UTIAntibiotic: Not specifiedAntibiotic: 1 year
  • UTI

  • Renal damage§¶

  • GFR (change)

  • Resolution of reflux

Source: university teaching hospitalCombined: Dx/HA copolymer implantation and antibioticsCombined: 1 month