A 2-year-old girl with grade III vesicoureteral reflux is started on continuous antibiotic prophylaxis. Which drug is most appropriate for long term nightly prophylaxis at this age?
- A Oral amoxicillin full therapeutic dose daily
- B Intramuscular ceftriaxone weekly
- C Nitrofurantoin single night dose ✓
- D Oral ciprofloxacin twice daily
Correct answer: C. Nitrofurantoin single night dose
Explanation
Continuous chemoprophylaxis for vesicoureteral reflux uses a single bedtime dose of an agent that achieves high urinary concentration without disturbing gut flora significantly. Nitrofurantoin and cotrimoxazole are the standard choices. Full therapeutic doses of amoxicillin rapidly select resistant organisms and are unsuitable for prophylaxis, fluoroquinolones are not first line in young children because of cartilage concerns, and parenteral therapy has no role here.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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