Evidence map›Paper›PMID 24795142›Full record

Trial reportThe New England journal of medicine2014

Antimicrobial prophylaxis for children with vesicoureteral reflux.

RIVUR Trial Investigators, Alejandro Hoberman, Saul P Greenfield, Tej K Mattoo, Ron Keren, Ranjiv Mathews, Hans G Pohl, Bradley P Kropp, Steven J Skoog, Caleb P Nelson and 3 more

Registry-linked trialOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The New England journal of medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00405704 (Randomized Intervention for Children With Vesicoureteral Reflux), which is not on this map. Cited by 175 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
175citing papers in PubMed, 9 pooled it
113.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00405704 phase3completednot on this map

Randomized Intervention for Children With Vesicoureteral Reflux (RIVUR)

TypeinterventionalSponsorNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)Ran2007 to 2014Enrolled607ConditionsVesicoureteral Reflux, Urinary Tract InfectionsArmsTrimethoprim-Sulfamethoxazole, Placebo
3 · Its place in the literature

Who cites it

175 citing papers in PubMed, 9 syntheses or guidelines pooled it, 612 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Interventions for primary vesicoureteric reflux.The Cochrane database of systematic reviews · 2019
    Pooled it
  6. Pooled it
  7. Pooled it
  8. Guideline
  9. Pooled it
  10. Innate immunity · 2020
    Trial
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Renal Scarring in the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) Trial.Clinical journal of the American Society of Nephrology : CJASN · 2016
    Trial
  16. Trial
  17. Article
  18. Article
  19. Urinary tract infections in children.Nature reviews. Urology · 2026
    Review
  20. Article

115 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 1 institution in 1 country.

RIVUR Trial Investigators
Alejandro Hoberman
Saul P Greenfield
Tej K Mattoo
Ron Keren
Ranjiv Mathews
Hans G Pohl
Bradley P Kropp
Steven J Skoog
Caleb P Nelson
Marva Moxey-Mims
Russell W Chesney
Myra A Carpenter
University of Pittsburgh · US

Funding

UNIVERSITY OF PITTSBURGH CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTE: BPCAUL1RR024153 · NCRR · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2006 to 2011
$73.9M
University of Pittsburgh Clinical and Translational Science InstituteUL1TR000005 · NCATS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2012 to 2015
$50.8M
Institutional Clinical and Translational Science AwardUL1TR000003 · NCATS · UNIVERSITY OF PENNSYLVANIA · PI FITZGERALD, GARRET A · 2012 to 2015
$38.9M
Randomized Intervention for Vesicoureteral Reflux (RIVUR)U01DK074059 · NIDDK · UNIV OF NORTH CAROLINA CHAPEL HILL · PI CARPENTER, MYRA A. · 2005 to 2012
$11.3M
POET Study: Clinical Trial of Girls with RefluxU01DK074063 · NIDDK · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI GREENFIELD, SAUL PHILIP · 2005 to 2012
$5.0M
RIVUR - Randomized Intervention for Children with Vesicoureteral RefluxU01DK074053 · NIDDK · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI HOBERMAN, ALEJANDRO · 2005 to 2012
$4.3M
RIVUR StudyU01DK074062 · NIDDK · WAYNE STATE UNIVERSITY · PI MATTOO, TEJ K · 2005 to 2012
$4.0M
Randomized Intervention for VesicolUreteral Reflux (RIVUR) StudyU01DK074064 · NIDDK · CHILDREN'S HOSP OF PHILADELPHIA · PI KEREN, RON · 2005 to 2012
$2.8M
Randomized Intervention for Vesico-Ureteral Reflux (RIVUR) TrialU01DK074082 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI WANG, MING-HSIEN · 2005 to 2012
$2.5M
Clinical Outcomes for Siblings of Children with Vesico-Ureteral RefluxK23DK088943 · NIDDK · BOSTON CHILDREN'S HOSPITAL · PI NELSON, CALEB PENNELL · 2010 to 2014
$892k
NCATS NIH HHS UL1TR000003NCATS NIH HHS UL1 TR000005NCATS NIH HHS UL1TR000005NCRR NIH HHS UL1 RR024153NCRR NIH HHS UL1RR024153NIDDK NIH HHS K23 DK088943NIDDK NIH HHS U01 DK074053NIDDK NIH HHS U01 DK074059NIDDK NIH HHS U01 DK074062NIDDK NIH HHS U01 DK074063NIDDK NIH HHS U01 DK074064NIDDK NIH HHS U01 DK074082
6 · The paper itself

Abstract

backgroundChildren with febrile urinary tract infection commonly have vesicoureteral reflux. Because trial results have been limited and inconsistent, the use of antimicrobial prophylaxis to prevent recurrences in children with reflux remains controversial.

methodsIn this 2-year, multisite, randomized, placebo-controlled trial involving 607 children with vesicoureteral reflux that was diagnosed after a first or second febrile or symptomatic urinary tract infection, we evaluated the efficacy of trimethoprim-sulfamethoxazole prophylaxis in preventing recurrences (primary outcome). Secondary outcomes were renal scarring, treatment failure (a composite of recurrences and scarring), and antimicrobial resistance.

resultsRecurrent urinary tract infection developed in 39 of 302 children who received prophylaxis as compared with 72 of 305 children who received placebo (relative risk, 0.55; 95% confidence interval [CI], 0.38 to 0.78). Prophylaxis reduced the risk of recurrences by 50% (hazard ratio, 0.50; 95% CI, 0.34 to 0.74) and was particularly effective in children whose index infection was febrile (hazard ratio, 0.41; 95% CI, 0.26 to 0.64) and in those with baseline bladder and bowel dysfunction (hazard ratio, 0.21; 95% CI, 0.08 to 0.58). The occurrence of renal scarring did not differ significantly between the prophylaxis and placebo groups (11.9% and 10.2%, respectively). Among 87 children with a first recurrence caused by Escherichia coli, the proportion of isolates that were resistant to trimethoprim-sulfamethoxazole was 63% in the prophylaxis group and 19% in the placebo group.

conclusionsAmong children with vesicoureteral reflux after urinary tract infection, antimicrobial prophylaxis was associated with a substantially reduced risk of recurrence but not of renal scarring. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others; RIVUR ClinicalTrials.gov number, NCT00405704.).

Indexed as

Anti-Infective Agents, UrinaryChildChild, PreschoolDouble-Blind MethodDrug Resistance, MicrobialFemaleFeverHumansInfantKaplan-Meier EstimateKidneyMaleSecondary PreventionTrimethoprim, Sulfamethoxazole Drug CombinationUrinary Tract InfectionsVesico-Ureteral RefluxAnti-Infective Agents, UrinaryTrimethoprim, Sulfamethoxazole Drug Combination

Identifiers

PMID24795142
PMCPMC4137319
OpenAlexW1485271732

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.