Paediatria Croatica
Non-antibiotic strategies for preventing urinary tract infections in children, with an emphasis on vesicoureteral reflux: a narrative review
By Helena Živić, Iva Palčić and Andrea Cvitković Roić.
Abstract
Context
Urinary tract infections (UTI) are among the most common bacterial infections in childhood. Children with vesicoureteral reflux (VUR) are at a higher risk for recurrent urinary tract infections (rUTI) and their sequelae. Long term antibiotic prophylaxis with rising antimicrobial resistance without preventing scarring prompted a search for alternatives.
Objective
To systematically evaluate the evidence for non-antibiotic uroinfection prevention strategies in children, with primary focus on children with VUR. Data Sources: Databases PubMed, Cochrane Library, Scopus, Web of Science, Embase and ClinicalTrials.gov were searched up to June 2026. Study Selection: A systematic review of databases was conducted according to PRISMA 2020 guidelines. Pediatric studies of non-antibiotic uroinfection prevention strategies with VUR were prioritized. Narrative synthesis was performed to summarise and interpret findings. Data Extraction: Study design, population, intervention and outcomes were extracted for each study.