What if antibiotics aren't as necessary as we think for infants with high-grade Vesico-urideral Reflex (VUR)? That's the question we dissect in this thought-provoking episode. We dive into a recent study from the New England Journal of Medicine, which took a close look at the use of continuous antibiotic prophylaxis to prevent the first symptomatic UTI in infants with high-grade VUR. We'll unpack the methods used in this Phase 3 multi-centered prospective randomized open-label trial, walk you through the criteria for the trial, and explore how the primary and secondary outcomes were determined.Did you know that about 70% of infants with high-grade VUR will never experience a UTI in their first two years? With this startling statistic in mind, we tackle the ongoing debate on whether to administer prophylaxis to infants with grade 3, 4, or 5 reflux. Hear us explore the evolving guidelines put forth by pediatricians and nephrologists and what this shifting perspective means for a system-wide approach to prophylaxis. This episode is a must-listen for healthcare professionals and parents alike who want to understand the risks and benefits of antibiotic prophylaxis in infants with high-grade VUR more comprehensively. As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!