Table 1.
Pooled results and certainty assessment of randomized clinical trials and observational studies involving children with one previous UTI (first clinical question).
| Certainty Assessment | No. of Patients | Effect | Certainty | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| No. of Studies | Study Design | Risk of Bias | Inconsistency | Indirectness | Imprecision | Other Considerations | Antibiotic Prophylaxis | No Prophylaxis | Relative (95% CI) |
Absolute (95% CI) |
|
| Risk of UTI recurrence (follow-up: mean 12 months; assessed as rates of recurrence) | |||||||||||
| 3 [20,21,22] | randomized trials | not serious a | not serious | not serious | serious b | none | 68/515 (13.2%) | 94/617 (15.2%) |
RR 0.87 (0.65 to 1.16) |
20 fewer per 1000 (53 fewer–24 more) |
⨁⨁⨁◯ Moderate |
| 1 [23] | observational studies | not serious c | not serious | not serious | very serious b | none | 19/128 (14.8%) | 64/483 (13.3%) |
HR 1.01 (0.50 to 2.02) |
1 more per 1000 (64 fewer–117 more) |
⨁◯◯◯ Very low |
| Risk of new renal scars (follow-up: mean 12 months; assessed as rates of new renal scars on DMSA scan) | |||||||||||
| 3 [20,21,22] | randomized trials | not serious a | not serious | not serious | serious b | none | 14/358 (3.9%) | 15/309 (4.9%) |
RR 0.81 (0.40 to 1.64) |
9 fewer per 1000 (29 fewer–31 more) |
⨁⨁⨁◯ Moderate |
| Risk of new antimicrobial resistances (follow-up: mean 12 months; assessed as rates of infections resistant to empiric antibiotics) | |||||||||||
| 1 [20] | randomized trials | not serious a | not serious | not serious | serious b | none | 24/288 (8.3%) | 13/288 (4.5%) |
RR 1.85 (0.96 to 3.55) |
38 more per 1000 (2 fewer–115 more) |
⨁⨁⨁◯ Moderate |
| 2 [23,25] | observational studies | not serious c | not serious | not serious | serious d | very strong association | 24/45 (53.3%) | 43/399 (10.8%) |
OR 4.49 (2.81 to 7.12) |
244 more per 1000 (146 more–355 more) |
⨁⨁⨁◯ Moderate |
| Risk of drug-related adverse events (follow-up: mean 12 months; assessed as rates of drug-related adverse event) | |||||||||||
| 2 [20,21] | randomized trials | not seriou a | not serious | not serious | not serious | strong association | 29/499 (5.8%) | 10/415 (2.4%) |
RR 2.41 (1.19 to 4.89) |
34 more per 1000 (5 more–94 more) |
⨁⨁⨁⨁ High |
CI: confidence interval; HR: hazard ratio; OR: odds ratio; RR: risk ratio. a: complete risk of bias analysis with results for single domains of the RoB2 tool is presented in Supplementary Materials. b: OIS criterion is not met and 95% CI overlaps no effect. c: complete risk of bias analysis with results for Newcastle–Ottawa Scale tool is presented in Supplementary Tables and Figures. d: OIS criterion is not met.