Rodriguez Esequiel, Weiss Dana A, Copp Hillary L
UCSF Department of Urology, University of California, 400 Parnassus Ave, A633 San Francisco, CA 94143-0738, USA.
Adv Urol. 2011;2011:134127. doi: 10.1155/2011/134127. Epub 2011 Mar 27.
Vesicoureteral reflux (VUR) affects approximately 1% of children and may predispose a child with a bladder infection to develop pyelonephritis and renal scarring. To prevent these potential sequelae, one accepted treatment option for VUR includes low-dose continuous antibiotic prophylaxis (CAP) to maintain urine sterility until the condition resolves. Despite the widespread use of CAP, little data exists regarding adherence to long-term antibiotic therapy. Not only will poor adherence to CAP potentially preclude the intended benefit, but also nonadherence with antibiotic regimens may carry untoward effects including unnecessary treatment changes for presumed antibiotic failure, emergence of resistant organisms, and compromised clinical trial outcomes. We present an overview of medication adherence in children with VUR, discuss possible consequences of nonadherence to antibiotic prophylaxis, and suggest ways to improve adherence. We raise awareness of issues related to nonadherence relevant to healthcare providers, investigators, and the community.
膀胱输尿管反流（VUR）影响约1%的儿童，可能使患有膀胱感染的儿童易患肾盂肾炎和肾瘢痕形成。为预防这些潜在的后遗症，一种公认的VUR治疗选择包括低剂量持续抗生素预防（CAP），以保持尿液无菌，直到病情缓解。尽管CAP被广泛使用，但关于长期抗生素治疗依从性的数据很少。CAP依从性差不仅可能排除预期的益处，而且不遵守抗生素治疗方案可能会带来不良影响，包括因假定的抗生素治疗失败而进行不必要的治疗调整、耐药菌的出现以及临床试验结果受损。我们概述了VUR患儿的药物依从性，讨论了不遵守抗生素预防的可能后果，并提出了提高依从性的方法。我们提高医疗保健提供者、研究人员和社区对与不依从相关问题的认识。
