Antibiotic Prophylaxis Cuts Recurrent UTI Risk by 50%

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.
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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.” 
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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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