📃 Paper Title: Nonantibiotic Prophylaxis for Recurrent Urinary Tract Infections: A Systematic Review and Meta Analysis of Randomized Controlled Trials
🧍 Author: Beerepoot
🕒 Year: 2013
📚 Journal: The Journal of Urology
🌎 Country: The Netherlands
ㅤContext to the study:
Can you tell me a study that did not show
a benefit for the use of lactobacili and oral oestrogens in reducing recurrent urinary tract infections?
ㅤ✅ Take-home message of study:
To prevent recurrent urinary tract infection (rUTI) with nonantibiotic methods:
Oral immunostimulant OM-89 is useful and decrease rUTI by ~40%
Vaginal estrogen can prevent rUTI in postmenopausal women (decrease by ~60%)
Vaginal vaccine Urovac, cranberry products and acupuncture appear to reduce rUTI, but further studies are required
Lactobacilli and oral oestrogens do not reduce rUTI based on current evidence
ㅤ Systematic review and meta-analysis
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Study participants:
Study Size:
2165 patients from 17 studies
Inclusion criteria:
All RCTs in adults with recurrent UTIs, mostly community dwelling women, comparing nonantibiotic prophylaxis to placebo or no treatment
Recurrent UTIs (rUTI) = at least 3 UTIs in the year preceding the start of the trial
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Key study outcomes:
Main outcome:
UTI occurrence rates during follow-up
Follow-up period: Between 20 weeks to 12 months
The oral immunostimulant OM-89 decreased the rate of rUTI (RR 0.61), with a good safety profile
The vaginal vaccine Urovac slightly reduced rUTI (RR 0.81). Primary immunization followed by booster immunization increased the time to reinfection
Vaginal estrogens appear to reduce risk of rUTI based on evidence from 2 studies (RR 0.42), but were associated with vaginal irritation (occurring in 6 - 20% of women)
Cranberries (RR 0.53) and acupuncture (RR 0.48) decreased rUTI
Oral estrogens and lactobacilli prophylaxis did not decrease rUTI
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Study Limitations:
Outcomes measure and use of definitions were not uniform in included studies
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