Urinary tract infections

Table of contents

Linked evidence summaries

• Antibiotic treatment appears to reduce the risk of pyelonephritis in pregnancy and appears to reduce the incidence of preterm delivery and low birthweight babies compared to placebo or no treatment.B
• Three days of antibiotic therapy is similar to 5-10 days in achieving symptomatic cure during uncomplicated UTI treatment, while the longer treatment appears to be more effective in obtaining bacteriological cure.A↑↑
• Oral antibiotic therapy appears to be as effective as parenteral or initial parenteral therapy for severe urinary tract infection.B
• 5-7 days of fluoroquinolone is effective for pyelonephritis in women compared with longer (10-14 days) treatment.A
• Single-dose treatment may be less effective than a 4–7 day course in the treatment of asymptomatic bacteriuria in pregnancy.C
• Continuous antibiotic prophylaxis using trimethoprim, nitrofurantoin, or cephalexin is effective in reducing the rate of recurrent UTI in non-pregnant women with uncomplicated UTIs, but side effects are common.A
• Trimethoprim or trimethoprim-sulfamethoxazole appears to increase the risk hyperkalaemia in the elderly using blockers of the renin-angiotensin system compared with amoxicillin.B
• Cranberry juice appears to decrease the number of symptomatic urinary tract infections (UTIs) in women with recurrent UTIs compared to placebo.B↑
• Vaginal oestrogens appear to be effective for reducing recurrent urinary tract infections compared to placebo in postmenopausal women.B
• Prophylaxis after predisposing events (like intercourse) reduces the incidence of recurrent cystitis.A
• Methenamine hippurate may be beneficial for preventing urinary tract infections (UTIs).C