Wang ZT, et al. - The Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) data were reanalyzed with the aim of using a risk classification system to recognize children who are more likely to benefit from continuous antibiotic prophylaxis (CAP). The RIVUR trial had concluded that children with vesicoureteral Reflux (VUR) benefitted from CAP. However, this reanalysis of the data demonstrated that high-risk children benefitted more with a number needed to treat of 5 compared to 18 in low-risk children. The clinical implications of these findings suggest a necessity for refining current indications for CAP in children with VUR, supporting a shift towards a ‘selective’ risk-based approach for management.