AI Article Synopsis
- Recurrent urinary tract infections (UTIs) are common, prompting a systematic review and meta-analysis to evaluate the effectiveness of antibiotic prophylaxis versus placebo in patients aged 12 and older with frequent UTIs.
- In placebo-controlled trials, prophylactic antibiotics reduced the risk of developing UTIs by 85%.
- When comparing different antibiotic treatments, there was no significant difference in effectiveness among nitrofurantoin, trimethoprim, and norfloxacin, and intermittent dosing was found to be as effective as continuous prophylaxis.
Article Abstract
Recurrent urinary tract infections are a common health problem. The only comprehensive synthesis on antibiotic prophylaxis in the last 15 years has been a guideline-embedded meta-analysis. We conducted a systematic review and meta-analysis of randomized controlled trials published up to October 13, 2020, evaluating patients age ≥12 years with either ≥2 episodes of lower urinary tract infection (UTI) within 6 months or ≥3 in the past year. Placebo or antibiotics were allowed as comparators. Study quality was low. In the 11 placebo-controlled trials, the risk for developing UTI was 85% lower with prophylaxis in comparison with placebo (risk ratio [RR], 0.15; 95% CI, 0.08-0.29). In the 9 head-to-head trials, the efficacy of the antibiotic agents appeared similar: The pooled RR indicated no difference between nitrofurantoin and comparators (RR, 1.01; 95% CI, 0.74-1.37), nor trimethoprim (+/- sulfamethoxazole; RR, 1.34; 95% CI, 0.89-2.03) or norfloxacin and comparators (RR, 1.17; 95% CI, 0.43-1.70). Studies comparing intermittent (postcoital) with continuous strategies revealed intermittent application to be equally effective.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9310516 | PMC |
| http://dx.doi.org/10.1093/ofid/ofac327 | DOI Listing |
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