In vesicoureteral reflux (VUR), what is the next step in management to help prevent infections and complications?

• A. Daily antibiotic prophylaxis
• B. Surgical correction
• C. Urine culture weekly
• D. No treatment

Answer: (A)

Vesicoureteral reflux increases the risk of recurrent urinary tract infections and potential renal scarring because bacteria can ascend from the bladder into the upper urinary tract. To prevent these infections and their complications, the typical next step is daily low-dose antibiotic prophylaxis. This approach reduces the likelihood of febrile UTIs by suppressing bacterial growth during bladder filling and periods of stasis, giving time for the reflux to resolve spontaneously as the child grows. Surgical correction is reserved for cases where medical management fails, the reflux is high-grade with persistent infections or renal impairment, or other specific indications are present. Regular urine cultures weekly aren’t a preventive strategy, and doing nothing would leave the child at ongoing risk for infection and damage.