Introduction: Antibiotic resistance in the treatment of urinary tract infections (UTIs) in the pediatric population is a matter of public health interest. The literature has not clearly established risk factors associated with the development of antibiotic resistance in cases of recurrent UTIs. It is necessary to determine the existence of an association between these risk factors and antibiotic resistance to reassess clinical management in these patients. Methodology: An analytical retrospective cohort observational study was conducted. Fifty-six patients with episodes of recurrent UTIs who attended a pediatric care institution between 2018 and 2022 were included. A descriptive analysis of the risk factor variables and antibiotic use in the first episode of UTI was performed. Bivariate and binomial logistic regression analyses were conducted to establish associations of the variables with antibiotic resistance. Results: The data were highly heterogeneous. Age ranged from 1 - 171 months (median 13.5, IQR 36.3). Twenty-five percent of the patients showed increased antibiotic resistance during recurrence, with a higher prevalence in females. No statistically significant associations were found between the variables. It is suggested to restart previous treatment in case of recurrence and not to increase antibiotic spectrum without clinical indication. Conclusion: Despite limitations, no factors related to antibiotic resistance between episodes were found. Within the framework of rational antibiotic use, it is suggested to empirically initiate the same antibiotic as in the first episode in case of recurrence.
