Pharmacological Agents to Decrease New Episodes of Recurrent Lower Urinary Tract Infections in Postmenopausal Women.
Omar Felipe Dueñas-Garcia1, Gina Sullivan, Cynthia D Hall
1From the UMass Memorial Medical Center, University of Massachusetts, Worcester, MA.
Female Pelvic Medicine & Reconstructive Surgery
|January 31, 2016
Summary
This systematic review found that antibiotics, vaginal estrogen, and oral lactobacillus can help prevent recurrent urinary tract infections (UTIs) in postmenopausal women. However, more research is needed due to limited data on treatment effectiveness and safety.
Area of Science:
- Urology
- Pharmacology
- Geriatrics
Background:
- Recurrent urinary tract infections (UTIs) significantly impact postmenopausal women's quality of life.
- Limited evidence exists on effective pharmacological interventions for preventing recurrent UTIs in this demographic.
Purpose of the Study:
- To systematically review and summarize pharmacological treatments for preventing recurrent UTIs in postmenopausal women.
- To evaluate randomized clinical trials (RCTs) assessing UTI recurrence prevention.
Main Methods:
- Comprehensive database searches (Excerpta Medica, Pubmed, Medline, Cochrane Library) were conducted.
- Included RCTs published from 1970 to 2015 focusing on UTI prevention in postmenopausal women.
- Nine eligible articles were identified for review.
Main Results:
- Antibiotics demonstrated the highest efficacy but carried a higher risk of systemic side effects.
- Oral lactobacilli showed non-inferiority to trimethoprim-sulfamethoxazole with a better safety profile in one study.
- Vaginal estrogen was less effective than continuous oral antibiotic suppression; oral estrogen was ineffective and caused side effects.
Conclusions:
- Antibiotic suppression, vaginal estrogen, and oral lactobacillus are supported for recurrent UTI prevention in postmenopausal women.
- This population remains understudied, with a need for further research on treatment efficacy and safety.
- Existing treatments should be used cautiously in older adults pending more data.
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