Antibiotic Prophylaxis Cuts Recurrent UTI Risk by 50%

New meta-analysis also found no significant difference in risk between antimicrobial agents in head-to-head trials.
New meta-analysis also found no significant difference in risk between antimicrobial agents in head-to-head trials.

SAN DIEGO—Antibiotic prophylaxis confers a 50% reduction in the risk of recurrent urinary tract infection (UTI) in non-pregnant women, according to the findings of a new meta-analysis presented at ID Week 2015.

The meta-analysis, by Julia Steinrücken, MD, and colleagues at Bern University Hospital in Bern, Switzerland, also found no significant difference in recurrent UTI risk between antimicrobial agents in head-to-head trials. Most of these trials compared nitrofurantoin with other agents.

In terms of efficacy, nitrofurantoin, norfloxacin, and trimethoprim/sulfamethoxazole appear to be interchangeable options for prophylaxis, Dr. Steinrücken's group concluded.

For the meta-analysis, the researchers considered any published randomized controlled trial (RCT) involving adult non-pregnant women for whom antibiotics were prescribed as prophylaxis against recurrent UTI. The meta-analysis included 14 placebo-controlled and 10 head-to-head trials and two studies of postcoital prophylaxis.

The researchers noted that the scientific literature on randomized trials for recurrent UTI prophylaxis has not been screened systematically for more than a decade, during which very few randomized controlled trials have been added to the literature.

Commenting on the study, Aaron E. Glatt, MD, a hospital epidemiologist at South Nassau Communities Hospital in Oceanside, N.Y., said the findings of the meta-analysis “are absolutely consistent with everything that we've known beforehand.”

Although antibiotic prophylaxis clearly helps patients with recurrent UTI, Dr. Glatt pointed out, the optimal regimen with respect to efficacy, toxicity, and cost remains unclear.

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