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

Continuous antibiotic prophylaxis using cotrimoxazole, nitrofurantoin, cephalexin, or a quinolone (norfloxacin, cinoxacin) is effective in reducing the rate of recurrent UTI in non-pregnant women with uncomplicated UTIs, but side effects are common.

A Cochrane review included 19 studies with a total of 1120 women. During active prophylaxis the rate range of microbiological recurrence patient-year (MRPY) was 0 to 0.9 person-year in the antibiotic group against 0.8 to 3.6 with placebo. The RR of having one microbiological recurrence (MR) was 0.21 (95% CI 0.13 to 0.34), favouring antibiotic and the NNT was 1.85. For clinical recurrences (CRPY) the RR was 0.15 (95% CI 0.08 to 0.28). The NNT was 1.85. The RR of having one MR after prophylaxis was 0.82 (95% CI 0.44 to 1.53). The RR for severe side effects was 1.58 (95% CI 0.47 to 5.28) and for other side effects the RR was 1.78 (CI 1.06 to 3.00) favouring placebo. Side effects included vaginal and oral candidiasis and gastrointestinal symptoms.

In women with UTI associated with sexual intercourse, post coital prophylaxis appered to be as effective as daily intake. No conclusions could be drawn about the optimal duration of prophylaxis, schedule or doses.

Ədəbiyyat

1. Albert X, Huertas I, Pereiró II, Sanfélix J, Gosalbes V, Perrota C. Antibiotics for preventing recurrent urinary tract infection in non-pregnant women. Cochrane Database Syst Rev 2004;(3):CD001209 (Last assessed as up-to-date: 21 March 2007).