The primary objective of our retrospective, descriptive study was to investigate practices at the University Hospitals of Nîmes and Montpellier regarding antibiotic prophylaxis for patients aged 1 to 3 years with congenital anomalies of the kidney and urinary tract (CAKUT). The secondary objective was to describe the clinical, microbiological, and therapeutic characteristics of this population of children.

Patients were selected from the hospital records of all children who underwent a cystography at Nîmes and Montpellier University Hospitals between 01/01/2019 and 31/12/2021.

Of the 79 patients with Grade 3 or higher vesicoureteral reflux (VUR3+), 86.8 % were treated with antibiotic prophylaxis (93.9 % with sulfamethoxazole-trimethoprim and 6.1 % with cefaclor). Of the 97 patients with other CAKUT, 47.3 % received an antibiotic prophylaxis (84.1 % with sulfamethoxazole-trimethoprim and 15.9 % with cefaclor). The percentages of patients who presented 1 or more febrile UTIs in the VUR3+ group with antibiotic prophylaxis and without prophylaxis were 84.8 % and 90.9 %, respectively. In the VUR3+ group, there was no significant difference between patients with antibiotic prophylaxis or not (p-value = 1) for having at least one episode of febrile UTI.

Based on our observational (real-world) data, there is no evidence for the benefit of antibiotic prophylaxis in children with VUR or other CAKUT.