Nitrofurantoin for preventing recurrent urinary tract infection during pregnancy

There is insufficient evidence on the effect of nitrofurantoin for preventing recurrent urinary tract infection during pregnancy.

Comment: The quality of evidence is downgraded by study limitations (unclear allocation concealment and blinding, and selective reporting) and by imprecise results (few outcome events and wide confidence intervals).

Summary

A Cochrane review included 1 study with a total of 200 subjects. A daily dose of nitrofurantoin and close surveillance (regular clinic visit, urine cultures and antibiotics when a positive culture was found) was compared with close surveillance only. No significant differences were found for the primary outcomes: recurrent pyelonephritis (RR 0.89, 95% CI 0.31 to 2.53, 1 study, n=167), recurrent urinary tract infection before birth (RR 0.30, 95% CI 0.06 to 1.38; 1 study, n=167) and preterm birth (before 37 weeks) (RR 1.18, 95% CI 0.42 to 3.35; 1 study, n=147). The incidence of asymptomatic bacteriuria (ASB) (at least 103 colonies per mL) (secondary outcome), only reported in women with a clinic attendance rate of more than 90% (RR 0.55, 95% CI 0.34 to 0.89; 1 study, n=102), was significantly reduced in women who received nitrofurantoin and close surveillance.

Clinical comments

Date of latest search: 26 July 2015

Ədəbiyyat

1. :Schneeberger C, Geerlings SE, Middleton P et al. Interventions for preventing recurrent urinary tract infection during pregnancy. Cochrane Database Syst Rev 2015;(7):CD009279. .