Influence of vesico-ureteral reflux on the response to treatment of urinary tract infections in female children.

3 groups of female children, comprising a total of 169 patients, were followed through successive episodes of urinary tract infection with respect to recurrence of infection. Group A consisted of 66 patients with no evidence of vesico-ureteral reflux. Group B comprised 42 patients with demonstrated vesico-ureteral reflux. The infections in these patients were treated with medical therapy alone and the reflux was not corrected. Group C consisted of 61 children who had surgical correction of vesico-ureteral reflux. While Groups B and C were not strictly comparable, the data indicate that there was no demonstrable difference in the rate of urinary tract infection among the 3 groups. Following short-term specific antibacterial therapy of a new infection, about 20% of children in each group were "cured", i.e., had no further infections during the 12 months or more that they were subsequently followed by the authors. Patients with less severe grades of reflux treated by medication alone (Group B) experienced no greater rate of reinfection than those children presenting with infections in the absence of vesico-ureteral reflux. In those children whose infections could not be adequately controlled by antimicrobial therapy, and those patients with severe (Grade III) reflux, surgery was performed to eliminate the vesico-ureteral reflux. The data also reinforced the concept that correction of reflux does not eliminate the need for constant vigilance and proper treatment of recurrent infections even after successful surgery has been carried out.