The objective of a multicenter randomized trial by E.H. Garin et al. (United States), was to assess the effect of primary vesicoureteral reflux (TME) on the incidence and severity of urinary tract infections and renal parenchyma damage in patients with acute pyelonephritis, and to determine whether antibiotic prophylaxis would lead to a decrease in the frequency and / or severity of urinary tract infections and / or lesions of the renal parenchyma in patients with mild or moderate MTCT.

Patients with acute pyelonephritis included in the study, some of whom had MTCT, received or did not receive antibiotic prophylaxis according to the randomization scheme. The group of patients receiving antibiotic prophylaxis did not differ significantly in age, sex and severity of MTCT, if any, from the control group.

The patients were followed for 1 year. A kidney scan with dimercaptosuccinic acid was performed every 6 months, as well as a relapse of urinary tract infections, accompanied by an increase in body temperature. A urinalysis and culture were performed at each visit to the doctor (once in 3 months). Kidney ultrasound and cystoureterography were performed at the end of the observation period.

Of the 236 patients (aged 3 months to 18 years) enrolled in the study, a one-year follow-up period was completed 218. According to the results obtained, there was no statistically significant difference between the two patient groups in the frequency of recurrence of urinary tract infections, types of relapse and the incidence of subsequent pyelonephritis and scarring of the renal parenchyma.

Thus, the presence of mild or moderate vesicoureteral reflux in a patient does not lead to an increase in the incidence of urinary tract infections, pyelonephritis or scarring of the renal parenchyma after acute pyelonephritis. In addition, during this study, the feasibility of antibiotic prophylaxis to prevent recurrence of infection and scarring of the renal parenchyma was not confirmed.