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Home All Specialties Chronic Disease

Quick Take: Continuous low-dose antibiotic prophylaxis for adults with repeated urinary tract infection (AnTIC)

byAliya Ramjaun
August 24, 2019
in Chronic Disease, Infectious Disease, Public Health, Urology
Reading Time: 1 min read
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Patients that use clean intermittent self-catheterization (CISC) are at an increased risk of repeated symptomatic urinary tract infections (UTIs). While the prevention of UTIs with continuous antibiotic prophylaxis in this patient population has been previously studied, results have been inconsistent. In this randomized controlled trial, 404 community-dwelling users of CISC with recurrent UTIs were randomized to receive either antibiotic prophylaxis once daily or no prophylaxis for 12 months, to determine whether continuous antibiotic prophylaxis reduces the incidence of symptomatic UTI. The antimicrobials given were 50 mg nitrofurantoin, 100 mg trimethoprim, or 250 mg cephalexin. Researchers found that the incidence of symptomatic antibiotic-treated UTI over the 12-month period was significantly reduced in the intervention group (RR 0.52, 95% CI 0.44 to 0.61, p<0.0001), corresponding to a 48% reduction. Antibiotic resistance was, however, more frequent in urinary isolates from the prophylaxis group. This study therefore shows that continuous antibiotic prophylaxis is effective in reducing UTI frequency in CISC users. The use of antibiotic prophylaxis, however, must be weighed against the increased risk of antibiotic resistance to urinary bacteria.

Click to read the study in Lancet Infectious Diseases

Image: PD

©2019 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: Antibiotic prophylaxisbacterial resistancecephalexinnitrofurantointrimethoprimurinary tract infection
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