Cost of non-antimicrobials for prophylaxis in the management of recurrent UTIs

ObjectiveThe aim of this paper was to look at the cost of the different non-antimicrobials available for the management of recurrent UTIs, and to compare these to the antimicrobials currently recommended for prophylaxis in the United Kingdom.MethodsFive non-antimicrobials (D-mannose, Probiotics/lactobacillus, Methenamine Hippurate, Oestrogens and Cranberry) and four antimicrobials (prophylactic dose Trimethoprim, Nitrofurantoin, Amoxicillin and Cefalexin) were included. The cost for 6 months of prophylactic treatment was calculated for each, with the median and range included for the non-prescription products.ResultsFor a 6-month duration, the median cost of Vaginal oestrogen, Cranberry, Methenamine Hippurate, Probiotics and D-mannose was £22.04, £55.95, £100.44, £139.5 and £158.40 respectively. Vaginal oestrogens were the cheapest non-antimicrobial management option with D-mannose being the most expensive. Trimethoprim was the cheapest of the antimicrobials for 6 months of prophylaxis (£5.08), followed by Cefalexin (£7.97), Amoxicillin (£10.71) and Nitrofurantoin (£16.32).ConclusionThe cost of antimicrobial management options for the prophylaxis of UTIs was found to be generally cheaper across the board, in comparison to non-antimicrobial products. However, the continuing public health crisis with regards to overprescribing of antimicrobials, growing resistance and the need for antimicrobial stewardship makes non-antimicrobials an ever-important consideration.