A:You are advised to get the kidney function tests as well as look for 24 hours urinary protein excretion. In case they are normal there may not be much reason to worry and the main important thing would be to prevent urinary tract infections through long term low dose antibiotic therapy. All measures should be taken to prevent infections and eradicate it. However, if the bacteria were sensitive to cotrimoxazole or Nitrofurantoin, it may be preferable to give either of the two in place of ofloxacin which he is on at present in view of the chances of early appearance of resistance with the latter. The grading of reflux is very important in deciding the future management. If the reflux is of low grade, surgery would not be required and only prevention of urinary tract infection has to be ensured. He would require periodic assessment of kidney function. A baseline DTPA scan repeated after about a years interval can be a useful tool. Additionally blood investigations including kidney function tests should be done and even if normal should be repeated at least once a year. He should have his routine exam of urine done at least once a month for he time being and once the infection is effectively under control the interval may be increased to 3 months.