Investigation and management of antenatally detected hydronephrosis.

The role of prophylactic antibiotics in children with ANH who are awaiting completion of postnatal investigations is controversial. Children with ANH have been shown to have a significantly higher risk of developing a urinary tract infection (UTI) than controls. While it is believed that prophylactic antibiotics will prevent urinary tract infections in children with VUR, it has yet to be proven. Therefore, some recommend institution of prophylactic antibiotics at birth; others instead recommend a low threshold for investigation and treatment of a suspected UTI. Commonly used prophylaxes in the neonate include amoxicillin 50 mg per day and cephalexin6 50 mg per day. Trimethoprim-sulfamatholxazole and nitrofurantoin should NOT be used in the neonate.