Document Type : original article
Authors
1
Assistant Professor, Department of pediatric nephrology, Faculty of Medicine, Sabzevar University of Medical Sciences, Khorasan Razavi, Iran
2
Community Medicine Department, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
3
Student Research Committee, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
10.22038/jpp.2025.91776.5603
Abstract
Background: Urinary tract infections (UTIs) are among the most common bacterial infections in children. While antibiotics are the mainstay of treatment, issues such as recurrence and antibiotic resistance necessitate exploring adjunctive therapies. This study aimed to evaluate the impact of combining probiotics with antibiotics on treatment response and recurrence in pediatric UTIs.
Methods: In this randomized clinical trial, 60 children (aged 1 month to 18 years) with confirmed UTIs (positive urinalysis and urine culture) were enrolled. Participants were randomly allocated to two groups: one received cefixime based on weight twice daily, and the other received the same cefixime regimen plus a daily probiotic (KidiLact powder). Urinalysis and urine culture were performed at baseline and followed up at one week, one month, two months, and three months after treatment initiation. The primary outcomes were the time to negative urine culture and the rate of UTI recurrence.
Results: After one week, the combination therapy group showed a higher rate of negative urine cultures (86.7% vs. 70%, p=0.117) and inactive urinalysis (73.3% vs. 63.3%, p=0.405) compared to the antibiotic-only group, though these differences were not statistically significant. By two months, 100% of the combination group achieved negative results, compared to 96.7% in the antibiotic-only group. At the three-month follow-up, the recurrence rate was significantly lower in the combination therapy group (3.3%, 1/30) than in the antibiotic-only group (6.7%, 2/30).
Conclusion: Adjunctive probiotic therapy with antibiotics may lead to a more rapid initial response and significantly reduce the recurrence of UTIs in children compared to antibiotic treatment alone. Probiotics represent a promising complementary approach to managing pediatric UTIs.
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