A 3-year-old girl is diagnosed with grade III vesicoureteral reflux on VCUG after her second febrile UTI. She has been started on prophylactic antibiotics. According to current guidelines, what is the recommended duration of prophylaxis in this scenario?
- A 3 months, then stop regardless of VUR status
- B 6 months, then repeat VCUG
- C Until VUR resolves or the child is no longer at risk of renal damage ✓
- D Lifelong prophylaxis is mandatory for all grades of VUR
Correct answer: C. Until VUR resolves or the child is no longer at risk of renal damage
Explanation
Continuous antibiotic prophylaxis (commonly with trimethoprim-sulfamethoxazole or nitrofurantoin) is recommended for children with VUR until the reflux resolves spontaneously or the child is no longer considered at risk for renal damage. The decision to stop depends on resolution of VUR on follow-up imaging, not a fixed duration. Lifelong prophylaxis is not indicated; many cases of low to moderate grade VUR resolve with age.
Reference: Indian Pediatrics / AAP Guidelines on UTI Management, 2016 revision ed.
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