Options of modern anti-relapse therapy for urinary tract infections in children: CRUTIL trial
Background. Recurrent urinary tract infection (UTI) is a serious problem in pediatric nephrology, affecting the quality of life and increasing the burden on the health system. Consideration of individual factors and the development of approaches to anti-relapse therapy, especially in children with...
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| Format: | Article |
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Zaslavsky O.Yu.
2019-03-01
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| Online Access: | http://kidneys.zaslavsky.com.ua/article/view/166663 |
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| author | D.D. Ivanov T.P. Ivanova O.G. Fedorenko S.V. Kushnirenko M.D. Ivanova |
| author_facet | D.D. Ivanov T.P. Ivanova O.G. Fedorenko S.V. Kushnirenko M.D. Ivanova |
| author_sort | D.D. Ivanov |
| collection | DOAJ |
| description | Background. Recurrent urinary tract infection (UTI) is a serious problem in pediatric nephrology, affecting the quality of life and increasing the burden on the health system. Consideration of individual factors and the development of approaches to anti-relapse therapy, especially in children without apparent objective reasons for the relapse of infection, is an urgent task. Materials and methods. A prospective, multicentre, randomized, parallel-group, open-label CRUTIL (Children’s Recurrent Urinary Tract Infections on bacterial Lysate) study was conducted, it included 83 children aged 3 to 15 years (8.0 ± 2.2 years) with recurrent UTI. The children were randomized into 3 groups: the first one — 22 patients who received supplementary therapy with Urivac lysate, the second one — 28 children who received supplementary therapy with Uro-Vaxom lysate, and the third group (controls) — 33 patients who received standard therapy. Duration of immunoactive therapy was 6 months, patients of these groups also received anti-relapse treatment with a single dose of urinary antiseptic at bedtime for 18 months; follow-up was 24 months. Results. In the first group of children who received Urivac, a 6-valent vaccine from bacterial lysates, a non-recurrent course to the end of the study was observed in 19 patients (87 %). In the group receiving Uro-Vaxom bacterial monolysates, 20 children (72 %) had non-recurrent course (odds ratio (OR) = 2.5; P > 0.05; the minimum expected effect was 4.84). Among those who did not receive urinary antiseptic at bedtime and bacterial lysates, the non-recurrent course was reported in 13 children (40 %) (P ≤ 0.05, OR = 0.26 with a 6-valent vaccine group). A 15% improvement in the effectiveness was obtained due to elimination of Pseudomonas aeruginosa and Enterococcus faecalis when using a 6-valent bacterial lysate. Subsequently, from 24 to 30 months of follow-up, 3 more children in the Uro-Vaxom group had a relapse (P ≤ 0.05 with the Urivac group). Conclusions. Bacterial lysates significantly increase the effectiveness of therapy for recurrent urinary tract infections in children. The best results in the formation of a non-recurrent course of relapsing UTI were obtained when using a prophylactic dose of urinary antiseptic once at bedtime and a 6-valent Urivac vaccine. |
| first_indexed | 2024-12-24T18:59:33Z |
| format | Article |
| id | doaj.art-66dc39eb0a3449ceb36aa83ac363c958 |
| institution | Directory Open Access Journal |
| issn | 2307-1257 2307-1265 |
| language | English |
| last_indexed | 2024-12-24T18:59:33Z |
| publishDate | 2019-03-01 |
| publisher | Zaslavsky O.Yu. |
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| spelling | doaj.art-66dc39eb0a3449ceb36aa83ac363c9582022-12-21T16:43:14ZengZaslavsky O.Yu.Počki2307-12572307-12652019-03-0182808710.22141/2307-1257.8.2.2019.166663166663Options of modern anti-relapse therapy for urinary tract infections in children: CRUTIL trialD.D. Ivanov0T.P. Ivanova1O.G. Fedorenko2S.V. Kushnirenko3M.D. Ivanova4Shupyk National Medical Academy of Postgraduate Education, Kyiv, UkraineNCSH “OHMATDYT”, Kyiv, UkraineMedical Practice of prof. D. Ivanov, Kyiv, UkraineShupyk National Medical Academy of Postgraduate Education, Kyiv, UkraineUniversità degli Studi di Milano-Bicocca, Milano, ItalyBackground. Recurrent urinary tract infection (UTI) is a serious problem in pediatric nephrology, affecting the quality of life and increasing the burden on the health system. Consideration of individual factors and the development of approaches to anti-relapse therapy, especially in children without apparent objective reasons for the relapse of infection, is an urgent task. Materials and methods. A prospective, multicentre, randomized, parallel-group, open-label CRUTIL (Children’s Recurrent Urinary Tract Infections on bacterial Lysate) study was conducted, it included 83 children aged 3 to 15 years (8.0 ± 2.2 years) with recurrent UTI. The children were randomized into 3 groups: the first one — 22 patients who received supplementary therapy with Urivac lysate, the second one — 28 children who received supplementary therapy with Uro-Vaxom lysate, and the third group (controls) — 33 patients who received standard therapy. Duration of immunoactive therapy was 6 months, patients of these groups also received anti-relapse treatment with a single dose of urinary antiseptic at bedtime for 18 months; follow-up was 24 months. Results. In the first group of children who received Urivac, a 6-valent vaccine from bacterial lysates, a non-recurrent course to the end of the study was observed in 19 patients (87 %). In the group receiving Uro-Vaxom bacterial monolysates, 20 children (72 %) had non-recurrent course (odds ratio (OR) = 2.5; P > 0.05; the minimum expected effect was 4.84). Among those who did not receive urinary antiseptic at bedtime and bacterial lysates, the non-recurrent course was reported in 13 children (40 %) (P ≤ 0.05, OR = 0.26 with a 6-valent vaccine group). A 15% improvement in the effectiveness was obtained due to elimination of Pseudomonas aeruginosa and Enterococcus faecalis when using a 6-valent bacterial lysate. Subsequently, from 24 to 30 months of follow-up, 3 more children in the Uro-Vaxom group had a relapse (P ≤ 0.05 with the Urivac group). Conclusions. Bacterial lysates significantly increase the effectiveness of therapy for recurrent urinary tract infections in children. The best results in the formation of a non-recurrent course of relapsing UTI were obtained when using a prophylactic dose of urinary antiseptic once at bedtime and a 6-valent Urivac vaccine.http://kidneys.zaslavsky.com.ua/article/view/166663recurrent urinary tract infections in childrenindustrial bacterial lysatesUrivacUro-Vaxomfollow-up in urinary tract infections |
| spellingShingle | D.D. Ivanov T.P. Ivanova O.G. Fedorenko S.V. Kushnirenko M.D. Ivanova Options of modern anti-relapse therapy for urinary tract infections in children: CRUTIL trial Počki recurrent urinary tract infections in children industrial bacterial lysates Urivac Uro-Vaxom follow-up in urinary tract infections |
| title | Options of modern anti-relapse therapy for urinary tract infections in children: CRUTIL trial |
| title_full | Options of modern anti-relapse therapy for urinary tract infections in children: CRUTIL trial |
| title_fullStr | Options of modern anti-relapse therapy for urinary tract infections in children: CRUTIL trial |
| title_full_unstemmed | Options of modern anti-relapse therapy for urinary tract infections in children: CRUTIL trial |
| title_short | Options of modern anti-relapse therapy for urinary tract infections in children: CRUTIL trial |
| title_sort | options of modern anti relapse therapy for urinary tract infections in children crutil trial |
| topic | recurrent urinary tract infections in children industrial bacterial lysates Urivac Uro-Vaxom follow-up in urinary tract infections |
| url | http://kidneys.zaslavsky.com.ua/article/view/166663 |
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