Nine children with nonobstructive urinary tract infections, 10 children with neurogenic bladders secondary to meningomyeloceles, and 2 children with ileal bladders have been studied in a double-blind program of medical management for recurrent urinary tract infections.
Observations indicate that some patients with nonobstructive recurrent UTI's may benefit from long-term chemoprophylaxis; however, the effective drug may vary from patient to patient. Furthermore, not all patients need continuous therapy, although initial clinical differentiation is not currently possible. In all patients, the essence of management consists of frequent, careful evaluation, with periodic assessment of anatomic and functional status of the urinary tract.
Among children with anatomic and physiologic abnormalities of the urinary tract, neither continuous chemotherapy nor therapy of asymptomatic bacteriuria appears beneficial.