Antibiotics for preventing recurrent urinary tract infection in non-pregnant women

Abstract

BackgroundUrinary tract infection (UTI) is a common health care problem. Recurrent UTI (RUTI) in healthy non-pregnant women is defined as three or more episodes of UTI during a twelve month period. Long-term antibiotics have been proposed as a prevention strategy for RUTI. ObjectivesTo determine the e icacy (during and a er) and safety of prophylactic antibiotics used to prevent uncomplicated RUTI in adult nonpregnant women. Search methodsWe searched MEDLINE (from 1966), EMBASE (from 1980), Cochrane Central Register of Controlled Trials (CENTRAL in The Cochrane Library) and reference lists of retrieved articles. Selection criteriaAny published randomised controlled trial where antibiotics were used as prophylactic therapy in RUTI. Data collection and analysisTwo reviewers independently assessed trial quality and extracted data. Statistical analyses were performed using the random e ects model and the results expressed as relative risk (RR) with 95% confidence intervals (CI). Main resultsNineteen studies involving 1120 women were eligible for inclusion. Antibiotics for preventing recurrent urinary tract infection in non-pregnant women (Review)

Recurrent Urinary Tract Infections Management in Women : A Review = الإلتهابات المتكررة للمسالك البولية عند النساء و طرق علاجها : مراجعة

“…Women with RUTIs were more likely to experience symptoms after intercourse, have a previous history of pyelonephritis, and experience rapid resolution of symptoms postantibiotic therapy than those women with irritative voiding symptoms. 5,6 Moreover, women with RUTIs were more unlikely to report nocturia and have symptoms between episodes of UTI than women without infection. The presence of irritative voiding symptoms between perceived episodes of UTI suggests a non-infectious cause as seen in interstitial cystitis, urethral syndrome or detrusor muscle overactivity.…”

“…34 A variety of antimicrobials are used for the prevention and management of RUTIs. 6,15,24,29,33,[38][39][40][41] A Cochrane review has shown that antibiotics in comparison to a placebo are more effective in preventing recurrences in pre-and postmenopausal women with RUTIs. 6 The criteria for the selection of the most effective antibiotic depend on a patient's pattern of resistance, adverse effects, interaction with drugs and cost.…”

“…One study showed that prophylaxis given weekly was more effective than one given monthly, but there is no study comparing daily and weekly regimes. 6,21,55 p o s t-c o i ta l a n t i b i o t i c p r o p h y l a x i s When a RUTI is related to sexual activity, post-coital therapy is considered an effective alternative prophylactic approach. 21,28,56 Postintercourse prophylaxis has fewer side effects than daily prophylaxis, as antibiotic consumption is reduced to only one-third.…”

“…4,5 The definition of recurrent urinary tract infection (RUTI) is three UTIs with three positive urine cultures during a 12-month period, or two infections during the previous 6 months. [5][6][7][8] This article provides an up-to-date review of the epidemiology, pathophysiology, risk factors, diagnosis, management and prevention of RUTIs in women. …”

Rekurentne infekcije mokraćnih puteva: antimikrobna i imunoaktivna profilaksa

“…Meta-analiza koju je sprovela Cochrane Database, a koja je obuhvatila 10 studija sa 430 žena, pokazala je da je posle primenjene kontinuirane terapije relativni rizik za ponovnu infekciju po bolesniku godišnje 0,15. Neželjena dejstva su bila vaginalna i oralna kandidijaza, gastrointestinalni simptomi i ospa [25]. Kontinuirana profilaksa antimikrobnim lekovima sprovodi se svakodnevno ili tri puta nedeljno tokom 6-12 meseci.…”