Urinary tract infection (UTI) is a common disease in children which occurs mostly at early life. Up to 30-40% of the children would suffer from recurrent infections following the first event. Vesico-ureteral reflux (VUR) has been considered to be associated with recurrent UTI which would lead to renal scarring. Meticulous diagnostic measures had been recommended for every child after the first-time febrile UTI in order to detect the VUR, and antimicrobial prophylactic therapy had been routinely recommended to patients with this disorder refluxing in order to prevent recurrent UTI. However, in recent years more selective diagnostic approaches were advocated and the benefit of antimicrobial prophylaxis has been questioned. This article reviews the evidence and rational for the current suggested recommendations of radiologic evaluation and antibiotic prophylaxis for children with first event of febrile UTI.
