Treatment of uncomplicated UTI in males: a systematic review of the literature

BJGP Open

Meera Tandan¹  Filip Jansaaker²  Karen Farrell³  Ildiko Gagyor⁴  Virginia Hernandez Santiago⁵  Gail Hayward⁶  Akke Vellinga⁷  Anja Maria Braend⁸  Marius Skow⁸  Ingvild Vik⁸ 

[1] Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US;Department of Clinical Microbiology, Rigshospitalet, Kobenhavn, Denmark;Department of General Practice, HRB Primary Care Clinical Trials Network Ireland, School of Medicine, National University of Ireland, Galway, Ireland;Department of General Practice, Universitatsklinikum Wurzburg, Wurzburg, Bavaria, Germany;Division of Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK;Nuffield Department of Primary Care Health Science, University of Oxford, Oxford, UK;School of Medicine, National University of Ireland, Galway, Ireland;The Antibiotic Centre for Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway;

关键词: male;    urinary tract infections;    antibiotic treatment;    primary health care;    randomised clinical trial;    review;   

DOI  :  10.3399/bjgpopen20X101140

来源: DOAJ

【 摘 要 】

Background: Urinary tract infections (UTIs) affect around 20% of the male population in their lifetime. The incidence of UTIs in men in the community is 0.9–2.4 cases per 1000 aged <55 years and 7.7 per 1000 aged ≥85 years. Aim: To evaluate the outcomes of randomised controlled trials (RCTs) comparing the effectiveness of different antimicrobial treatments and durations for uncomplicated UTIs in adult males in outpatient settings. Method: A systematic literature review of RCTs of adult male patients with an uncomplicated UTI treated with oral antimicrobials in any outpatient setting. The outcomes were symptom resolution within 2 weeks of starting treatment, duration until symptom resolution, clinical cure, bacteriological cure, and frequency of adverse events. Results: From the 1052 abstracts screened, three provided sufficient information on outcomes. One study compared trimethoprim-sulfamethoxazole for 14 days (21 males) with 42 days (21 males). Fluoroquinolones were compared in the two other RCTs: lomefloxacin (10 males) with norfloxacin (11 males), and ciprofloxacin for 7 days (19 males) and 14 days (19 males). Combining the results from the three RCTs shows that for 75% males with a UTI (76/101) bacteriological cure was reported at the end of the study. Of the 59 patients receiving a fluoroquinolone, 57 (97%) reported bacteriological and clinical cure within 2 weeks after treatment. Conclusion: The evidence available is insufficient to make any recommendations in relation to type and duration of antimicrobial treatment for male UTIs. Sufficiently powered RCTs are needed to identify best treatment type and duration for male UTIs in primary care.

【 授权许可】

Unknown