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src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-niceng112er1-lrg.png" alt="Cover of Evidence review for the effectiveness of methenamine hippurate in the prevention of recurrent urinary tract infections (UTIs)" /></a></div><div class="bkr_bib"><h1 id="_NBK611982_"><span itemprop="name">Evidence review for the effectiveness of methenamine hippurate in the prevention of recurrent urinary tract infections (UTIs)</span></h1><div class="subtitle">Urinary tract infection (recurrent): antimicrobial prescribing</div><p><b>Evidence review A</b></p><p><i>NICE Guideline, No. 112</i></p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2024 Dec</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-3126-2</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2024.</div></div><div class="bkr_clear"></div></div><div id="niceng112er1.s1"><h2 id="_niceng112er1_s1_">1. Context</h2><div id="niceng112er1.s1.1"><h3>1.1. Background</h3><p>Urinary tract infection (UTI) is a non-specific term that refers to infection anywhere in the urinary tract. This evidence review covers the prevention of UTI in women (including pregnant women), men and children with recurrent UTI, who do not have a catheter. <a href="https://www.nice.org.uk/guidance/NG109" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Lower UTI</a>, <a href="https://www.nice.org.uk/guidance/NG111" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">acute pyelonephritis</a>, and <a href="https://www.nice.org.uk/guidance/indevelopment/gid-apg10005" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">catheter-associated UTI</a> are covered in separate evidence reviews.</p><p>Recurrent UTI includes recurrence of lower UTIs (cystitis) and/or upper UTIs (acute pyelonephritis), but repeated pyelonephritis should prompt further investigation. See NICE antimicrobial prescribing guidelines on <a href="https://www.nice.org.uk/guidance/NG109" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">lower UTI</a> and <a href="https://www.nice.org.uk/guidance/NG111" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">acute pyelonephritis</a> for background information.</p><p>Recurrent UTIs are repeated UTIs with a frequency of at least 3 UTIs in the last year or 2 UTIs in the last 6 months (<a href="http://uroweb.org/guideline/urological-infections/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">European Association of Urology (EAU) guidelines on urological infections</a> [2017]). This may be due to relapse or reinfection:
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<ul><li class="half_rhythm"><div>Relapse is recurrent UTI with the same strain of organism. Relapse is the likely cause if UTI recurs within a short period (for example within 2 weeks) after treatment.</div></li><li class="half_rhythm"><div>Reinfection is recurrent UTI with a different strain or species of organism. Reinfection is the likely cause if UTI recurs more than 2 weeks after treatment.</div></li></ul></p><p>The number of recurrences that is regarded as clinically significant depends on the risks of infection and the impact of UTI on the person (EAU guideline [2017]). Lower UTI (cystitis) recurs within a year in 25 to 50% of women, usually as reinfections (rather than relapses) (NICE clinical knowledge summary – <a href="https://cks.nice.org.uk/urinary-tract-infection-lower-women" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">UTI (lower) - women</a>).</p><p>Recurrent UTIs are common in women. Risk factors in young and pre-menopausal women include sexual intercourse, new sexual partner, mother with a history of UTI and history of UTI as a child. In post-menopausal and elderly women, risk factors include history of UTI before menopause, urinary incontinence, atrophic vaginitis due to oestrogen deficiency, increased post-void urine volume, and urine catheterisation and functional status deterioration in elderly institutionalised women (EAU guideline [2017]).</p><p>Some people (mainly women) may be able to identify 1 or more triggers that often brings on a UTI. These triggers may vary for different people, and include sexual intercourse, going for long walks and wearing occlusive underwear.</p><p>Risk factors that may predispose men to recurrent UTIs include abnormalities of urinary tract function or structure, incomplete bladder emptying and immunosuppression (NICE clinical knowledge summary – <a href="https://cks.nice.org.uk/urinary-tract-infection-lower-men" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">UTI (lower) - men</a>).</p><p>Risk factors for recurrent UTI in children include abnormalities of urinary tract function or structure, for example vesicoureteric reflux, spinal abnormalities and constipation; dysfunctional elimination syndrome; and infection or irritation of the genital area that prevents regular voiding (NICE clinical knowledge summary – <a href="https://cks.nice.org.uk/urinary-tract-infection-children" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">UTI - children</a>).</p><p>The diagnosis of recurrent UTI should be confirmed by urine culture. Extensive routine investigations such as cystoscopy and imaging are not routinely recommended, but may be performed in some circumstances such as when renal calculi or outflow obstruction is suspected (EAU guideline [2017]).</p><p>The management of suspected community-acquired bacterial urinary tract infection in adults aged 16 years and over is covered in the NICE quality standard on <a href="https://www.nice.org.uk/guidance/qs90" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">urinary tract infection in adults</a> (2015). This includes women who are pregnant, people with indwelling catheters and people with other diseases or medical conditions such as diabetes. The quality standard was developed to contribute to a reduction in emergency admissions for acute conditions that should not usually require hospital admission, and improvements in health-related quality of life. It includes a <a href="https://www.nice.org.uk/guidance/qs90/chapter/Quality-statement-7-placeholder-Treatment-of-recurrent-urinary-tract-infection" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">placeholder statement</a> on the treatment of recurrent UTI, which is an area of care that has been prioritised by the Quality Standards Advisory Committee but for which no source guidance was currently available. A placeholder statement indicates the need for evidence-based guidance to be developed in this area.</p><p>The NICE guideline on <a href="https://www.nice.org.uk/guidance/cg54" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">urinary tract infection in under 16s</a> (2007) defines recurrent UTI in children as:
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<ul><li class="half_rhythm"><div>2 or more episodes of UTI with acute pyelonephritis/upper UTI, or</div></li><li class="half_rhythm"><div>1 episode of UTI with acute pyelonephritis plus 1 or more episode of UTI with cystitis/lower UTI, or</div></li><li class="half_rhythm"><div>3 or more episodes of UTI with cystitis/lower UTI.</div></li></ul></p><p>The NICE guideline on urinary tract infection in under 16s (2007) makes recommendations on the diagnosis of UTI in infants and children. All infants younger than 3 months with suspected UTI should be referred to paediatric specialist care and a urine sample should be sent for urgent microscopy and culture. These infants should be managed in accordance with the recommendations for this age group in the NICE guideline on <a href="https://www.nice.org.uk/guidance/cg160" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">fever in under 5s</a> (2013). Infants and children who have had recurrent UTIs should undergo ultrasound (within 6 weeks) (see the NICE guideline on urinary tract infection in under 16s (2007) for more information).</p><p>UTIs are usually caused by bacteria from the gastrointestinal tract entering the urethra and ascending into the bladder. The most common causative pathogen in uncomplicated UTIs, in 70 to 95% of cases, is <i>Escherichia coli</i> (<i>E. coli</i>). <i>Staphylococcus saprophyticus</i> accounts for 5 to 10% of cases and occasionally other Enterobacteriaceae, such as <i>Proteus mirabilis</i> and Klebsiella species are isolated.</p></div><div id="niceng112er1.s1.2"><h3>1.2. Managing infections that require antibiotics</h3><p>In most cases, managing a UTI will require antibiotic treatment, but antibiotics should only be started when there is clear evidence of infection. Antibiotic prophylaxis may also be an option in people with recurrent UTI, to reduce the risk of recurrent infections. The NICE guideline on urinary tract infection in under 16s (2017) recommends that antibiotic prophylaxis may be considered in infants and children with recurrent UTI.</p><div id="niceng112er1.s1.2.1"><h4>1.2.1. Self-care</h4><p>The NICE guideline on <a href="https://www.nice.org.uk/ng63" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">antimicrobial stewardship: changing risk-related behaviours in the general population</a> (2017) recommends that people should be given verbal advice and written information that they can take away about how to manage their infection themselves at home with self-care if it is safe to do so.</p><p>Self-care options that have been used to relieve symptoms in UTI include paracetamol or non-steroidal anti-inflammatory drugs, cranberry products and urine alkalinising agents. Other strategies have also been used to reduce the risk of recurrent infections. These include avoiding known risk factors, behavioural changes (for example, reducing fluid intake, habitual and post-coital delayed urination and wearing occlusive underwear), probiotics, cranberry products and D-mannose (see <a href="#niceng112er1.s3">Clinical effectiveness</a>).</p></div><div id="niceng112er1.s1.2.2"><h4>1.2.2. Back-up antibiotic prescribing strategies</h4><p>The NICE guideline on antimicrobial stewardship: changing risk-related behaviours in the general population (2017) recommends that if the person has been given a <a href="https://www.nice.org.uk/Glossary?letter=B" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">back-up antibiotic prescription</a>, they should be told:
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<ul><li class="half_rhythm"><div>How to self-care to manage their symptoms.</div></li><li class="half_rhythm"><div>What the antimicrobials would be used for, if needed.</div></li><li class="half_rhythm"><div>How to recognise whether they need to use the antimicrobials, and if so:
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<ul class="circle"><li class="half_rhythm"><div>how to get them</div></li><li class="half_rhythm"><div>when to start taking or using them</div></li><li class="half_rhythm"><div>how to take them.</div></li></ul></div></li></ul></p></div><div id="niceng112er1.s1.2.3"><h4>1.2.3. Antibiotic prescribing strategies</h4><p>The NICE guideline on <a href="https://www.nice.org.uk/ng15" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">antimicrobial stewardship: systems and processes for effective antimicrobial medicine use</a> (2015) recommends that when antimicrobials are prescribed, prescribers should:
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<ul><li class="half_rhythm"><div>Consider supplying antimicrobials in pack sizes that correspond to local (where available) and national guidelines on course lengths.</div></li><li class="half_rhythm"><div>Follow local (where available) or national guidelines on prescribing the shortest effective course, the most appropriate dose, and route of administration.</div></li><li class="half_rhythm"><div>Undertake a clinical assessment and document the clinical diagnosis (including symptoms) in the patient's record and clinical management plan.</div></li><li class="half_rhythm"><div>Document in the patient's records (electronically wherever possible):
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<ul class="circle"><li class="half_rhythm"><div>the reason for prescribing an antimicrobial</div></li><li class="half_rhythm"><div>the plan of care as discussed with the patient, their family member or carer (as appropriate), including the planned duration of any treatment.</div></li></ul></div></li><li class="half_rhythm"><div>Take into account the benefits and harms for an individual patient associated with the particular antimicrobial, including:
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<ul class="circle"><li class="half_rhythm"><div>possible interactions with other medicines or any food and drink</div></li><li class="half_rhythm"><div>the patient's other illnesses, for example, the need for dose adjustment in a patient with renal impairment</div></li><li class="half_rhythm"><div>any drug allergies (these should be documented in the patient's record)</div></li><li class="half_rhythm"><div>the risk of selection for organisms causing healthcare associated infections, for example, <i>C. difficile</i>.</div></li></ul></div></li><li class="half_rhythm"><div>Document in the patient's records the reasons for any decision to prescribe outside local (where available) or national guidelines.</div></li></ul></p><p>The NICE guideline on antimicrobial stewardship: changing risk-related behaviours in the general population (2017) recommends that resources and advice should be available for people who are prescribed antimicrobials to ensure they are taken as instructed at the correct dose, via the correct route, for the time specified. Verbal advice and written information that people can take away about how to use antimicrobials correctly should be given, including:
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<ul><li class="half_rhythm"><div>not sharing prescription-only antimicrobials with anyone other than the person they were prescribed or supplied for</div></li><li class="half_rhythm"><div>not keeping them for use another time</div></li><li class="half_rhythm"><div>returning unused antimicrobials to the pharmacy for safe disposal and not flushing them down toilets or sinks.</div></li></ul></p></div></div><div id="niceng112er1.s1.3"><h3>1.3. Safety netting advice</h3><p>The NICE guideline on antimicrobial stewardship: changing risk-related behaviours in the general population (2017) recommends that safety netting advice should be shared with everyone who has an infection (regardless of whether or not they are prescribed or supplied with antimicrobials). This should include:
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<ul><li class="half_rhythm"><div>how long symptoms are likely to last with and without antimicrobials</div></li><li class="half_rhythm"><div>what to do if symptoms get worse</div></li><li class="half_rhythm"><div>what to do if they experience adverse effects from the treatment</div></li><li class="half_rhythm"><div>when they should ask again for medical advice.</div></li></ul></p><p>The NICE clinical knowledge summary on UTI (lower) - women suggests advising all women with recurrent UTI to seek medical attention if they:
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<ul><li class="half_rhythm"><div>develop fever or loin pain, because of suspected acute pyelonephritis, or</div></li><li class="half_rhythm"><div>do not respond to treatment with the first-choice antibiotic, because this may be due to a resistant organism.</div></li></ul></p><p>For men with recurrent UTI, the NICE clinical knowledge summary on UTI (lower) – men suggests that men are advised about measures that may reduce the risk of recurrent UTIs, such as to maintain sufficient fluid intake (at least 2 litres per day) to avoid dehydration. If hospital admission is not needed and empirical antibiotics are started, follow up should be arranged, for example after 48 hours, to check the response to treatment and the urine culture results. If symptoms persist after antibiotic treatment referral for specialist urological assessment may be needed.</p><p>The NICE guideline on urinary tract infection in under 16s (2007) recommends that all infants younger than 3 months with suspected UTI should be referred immediately to paediatric specialist care. All infants and children 3 months or older with recurrent UTI should be assessed by a paediatric specialist.</p></div><div id="niceng112er1.s1.4"><h3>1.4. Symptoms and signs of a more serious illness or condition (red flags)</h3><p>Complications of lower UTI include ascending infection leading to pyelonephritis, renal failure, and sepsis.</p><p>The NICE clinical knowledge summary on UTI (lower) - women suggests routinely referring the following women with recurrent UTIs:
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<ul><li class="half_rhythm"><div>who have a risk factor for an abnormality of the urinary tract</div></li><li class="half_rhythm"><div>who are immunocompromised or who have diabetes</div></li><li class="half_rhythm"><div>who have a known abnormality of their renal tract who might benefit from surgical correction</div></li><li class="half_rhythm"><div>who have not responded to preventive treatments.</div></li></ul></p><p>In pregnancy, asymptomatic bacteriuria can lead to pyelonephritis; and symptomatic UTI has been associated with developmental delay or cerebral palsy in the infant, and foetal death. For women with visible or non-visible haematuria an urgent 2-week wait referral should be arranged if a urological cancer is suspected (NICE clinical knowledge summary on UTI (lower) – women).</p><p>For men with recurrent UTI, the NICE clinical knowledge summary on UTI (lower) – men suggests that alternative conditions such as urethritis are considered. At least 50% of men with recurrent UTI will have prostate involvement, which may lead to complications such as prostatic abscess or chronic bacterial prostatitis. Urinary stones are also a possibility, more likely with <i>Proteus mirabilis</i> infection which is associated with stone formation in the renal collecting ducts. Emergency admission to hospital is recommended if a man with a suspected lower UTI is severely unwell with symptoms or signs suggestive of urosepsis (for example nausea and vomiting, confusion, tachypnoea, tachycardia, or hypotension). If hospital admission is not needed and empirical antibiotics are started, follow up should be arranged, for example after 48 hours, to check the response to treatment and the urine culture results. If symptoms persist after antibiotic treatment referral for specialist urological assessment may be needed.</p><p>Treatment failure (due to relapse or reinfection) is more likely in men with risk factors for complications (see NICE antimicrobial prescribing guideline on UTI: acute pyelonephritis). Prognosis partly depends on whether any underlying cause can be treated or removed, such as urinary stone extraction. For men with suspected urological cancer an urgent 2-week referral should be arranged. A non-urgent referral for bladder cancer should be considered in men aged 60 years and over with recurrent or persistent unexplained UTI (NICE clinical knowledge summary – UTI (lower) – men).</p><p>In children, UTIs can lead to renal scarring, but more often this is preceded by acute pyelonephritis rather than cystitis, and it is more common in children with vesicoureteral reflux. UTIs in childhood have also been associated with hypertension (if there is severe or bilateral renal scarring) and renal insufficiency or failure (if febrile UTIs are treated late; NICE clinical knowledge summary on UTI - children).</p></div><div id="niceng112er1.s1.5"><h3>1.5. 2024 Guideline update</h3><p>An update of this guideline was conducted in 2024 which made new recommendations, or updated existing recommendations, in the below areas.</p><div id="niceng112er1.s1.5.1"><h4>1.5.1. Methenamine hippurate</h4><p>Methenamine hippurate is an antiseptic drug and was within the scope of the 2018 guideline as an antimicrobial pharmacological intervention. However, methenamine hippurate was classified as an antibiotic so it was grouped with antibiotics in the <a href="#niceng112er1.s3">Clinical effectiveness</a> and <a href="#niceng112er1.s4">Safety and tolerability sections</a> of this evidence review. No recommendations were made on the use of methenamine hippurate in the 2018 guideline.</p><p>As a result of <a href="https://www.nice.org.uk/guidance/ng112/resources/2022-exceptional-surveillance-of-urinary-tract-infection-recurrent-antimicrobial-prescribing-nice-guideline-ng112-11187931213/chapter/Surveillance-decision?tab=evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">exceptional surveillance in 2022</a>, a new evidence review was conducted to examine the evidence on the effectiveness of methenamine hippurate prophylaxis as an alternative to antibiotic prophylaxis for treating recurrent UTI. In the 2024 evidence review, methenamine hippurate was classified as an antiseptic to clarify the distinction from antibiotics. Evidence supporting the 2024 recommendations on methenamine hippurate is described in the 2024 evidence review and does not draw on the evidence on methenamine hippurate described in this evidence review.</p></div><div id="niceng112er1.s1.5.2"><h4>1.5.2. Oestrogen</h4><p>After publication of the 2018 guideline, stakeholder feedback was received regarding the recommendation on vaginal oestrogen and what was meant by the ‘lowest effective dose’. The wording of the existing recommendation was reviewed by the committee for the 2024 update to improve clarity and implementation. They agreed that the phrase ‘lowest effective dose’ was confusing and were aware that the BNF contains information about recommended doses, so they removed this from the recommendation. They also removed the example of estriol cream from the recommendation and agreed that preferences for different types of vaginal oestrogen preparations should be discussed with the person because they did not want to imply that estriol cream was the preferred preparation; the 2018 committee agreed they could not make firm conclusions from the evidence or their experience about different vaginal oestrogen products.</p><p>The 2024 guideline committee discussed all the 2018 recommendations on oestrogen and agreed that these should be extended to cover the perimenopausal stage. The committee agreed, based on their knowledge and experience, that recurrent UTI often first occurs when oestrogen starts to decline in the perimenopausal period, which can last many years. The committee were concerned that limiting the use of vaginal oestrogen to after menopause would mean either unnecessarily delaying a potentially beneficial treatment, perhaps for years, or that more people may receive antibiotic prophylaxis than necessary. Therefore, although the evidence on oestrogen was not reviewed as part of the 2024 update, the committee agreed updating the recommendations to be more inclusive was essential from both an equality perspective and to support antimicrobial stewardship aims.</p><p>The 2018 guideline recommended that possible adverse effects and the uncertainty of endometrial safety with long-term or repeated use of oestrogens was discussed to ensure shared decision-making. However, there were concerns that this recommendation may have been informed from evidence on high dose vaginal oestrogens that are not used in the UK. Therefore, the committee agreed that the point about endometrial safety should be removed from the recommendation. The committee were aware of the Medicines and Healthcare products Regulatory Agency [MHRA] drug safety update on hormone replacement therapy (2019) and they agreed it was important for prescribers to discuss this with people and that they should be reassured that serious side effects are very rare when using vaginal oestrogen. They also included a cross-reference to the NICE guideline on menopause for information about the use of vaginal oestrogen for people with a history of breast cancer. The committee agreed to align the example vaginal oestrogen treatments named in the recommendation as treatment options with <a href="https://www.nice.org.uk/guidance/indevelopment/gid-ng10241" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NICE’s guideline on menopause</a> (updated in 2024) by including gel, tablet and pessary. The evidence for the updated menopause guideline included a wide range of treatment methods. The original evidence for this guideline from 2018 indicated that vaginal oestrogen administered via a pessary was less effective than oral antibiotic at reducing the risk of recurrent infection in women after the menopause. However, this came from low quality evidence that dated back to 2008.The 2024 committee discussed the importance of patient preference for different treatment modes.</p><p>The committee also agreed that the recommendation on not offering oral oestrogens should be amended to include all systemic hormone therapy because there are high dose oestrogen products available in non-oral preparations and, in the committee’s experience, these should not be used to for recurrent UTI due to risks associated with higher doses of oestrogen.</p></div><div id="niceng112er1.s1.5.3"><h4>1.5.3. Use of gender-inclusive language and the explicit inclusion of trans and non-binary people in the guideline recommendations</h4><p>The committee for the 2024 update reviewed the language of the recommendations to bring them up to date and address equality issues. The committee agreed that recommendations for women in the 2018 guideline should also apply to trans men and non-binary people with a female urinary system. Similarly, recommendations for men should also apply to trans women and non-binary people with a male genitourinary system.</p><p>The committee discussed that there was no evidence to inform how recommendations should apply to people who have had gender reassignment surgery that involved structural alteration of the urethra. They did not want to explicitly exclude people who have had gender reassignment surgery from the recommendations as, in their experience, some of the recommendations may be beneficial for these groups. However, they agreed that when considering different management options in this population specialist advice should always be sought. Therefore, they agreed to include people who have had gender reassignment surgery that involved structural alteration of the urethra in the recommendation on referral and seeking specialist advice.</p></div></div></div><div id="niceng112er1.s2"><h2 id="_niceng112er1_s2_">2. Evidence selection</h2><p>A range of evidence sources are used to develop antimicrobial prescribing guidelines. These fall into 2 broad categories:
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<ul><li class="half_rhythm"><div>Evidence identified from the literature search (see <a href="#niceng112er1.s2.1">section 2.1</a> below)</div></li><li class="half_rhythm"><div>Evidence identified from other information sources. Examples of other information sources used are shown in the <a href="https://www.nice.org.uk/Media/Default/About/what-we-do/NICE-guidance/antimicrobial%20guidance/Interim-process-methods-guide-antimicrobial-guidelines.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">interim process guide</a> (2017).</div></li></ul></p><p>See <a href="#niceng112er1.appa">appendix A: evidence sources</a> for full details of evidence sources used.</p><div id="niceng112er1.s2.1"><h3>2.1. Literature search</h3><p>A literature search was developed to identify evidence for the effectiveness and safety of interventions for managing all urinary tract infections (UTIs) (see <a href="#niceng112er1.appc">appendix C: literature search strategy</a> for full details). The literature search identified 6,695 references. These references were screened using their titles and abstracts and 133 full text references were obtained and assessed for relevance. Thirty-eight full text references of <a href="https://www.nice.org.uk/Glossary?letter=S" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">systematic reviews</a> and <a href="https://www.nice.org.uk/Glossary?letter=R" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">randomised controlled trials</a> (RCTs) were assessed as relevant to the guideline review question (see <a href="#niceng112er1.appb">appendix B: review protocol</a>). Ten percent of studies were screened to establish inter-rater reliability, and this was within the required threshold of 90%.</p><p>Thirteen of the 38 references were prioritised by the committee as the best available evidence and were included in this evidence review (see <a href="#niceng112er1.appf">appendix F: included studies</a>). The methods for identifying, selecting and prioritising the best available evidence are described in the <a href="https://www.nice.org.uk/Media/Default/About/what-we-do/NICE-guidance/antimicrobial%20guidance/Interim-process-methods-guide-antimicrobial-guidelines.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">interim process guide</a>.</p><p>The 25 references that were not prioritised for inclusion are listed in <a href="#niceng112er1.appi">appendix I: studies not prioritised</a>. Also see <a href="#niceng112er1.appe">appendix E: evidence prioritisation</a> for more information on study selection.</p><p>The remaining 95 references were excluded. These are listed in <a href="#niceng112er1.appj">appendix J: excluded studies</a> with reasons for their exclusion.</p><div id="niceng112er1.box1" class="box boxed-text-box whole_rhythm hide-overflow"><p>Four further systematic reviews were identified following stakeholder consultation and an updated search (May 2018). Luis et al. (2017) is a systematic review and Ledda et al. (2017) is an RCT both covering cranberry products, however, both studies were deprioritised as another systematic review also identified following stakeholder consultation on the same intervention was prioritised (<a class="bibr" href="#niceng112er1.appf.ref4" rid="niceng112er1.appf.ref4">Fu et al. [2017)</a>]; see <a href="#niceng112er1.appi">appendix I: studies not prioritised</a>). Fu et al. conducted a meta-analysis comparing cranberry products with placebo or no treatment in non-pregnant women. A third systematic review (<a class="bibr" href="#niceng112er1.appf.ref10" rid="niceng112er1.appf.ref10">Roshdibonab et al. [2017)</a>]) conducted the same comparison in children and was also included in the guideline. The remaining 15 references identified in the updated search were excluded. These are listed in <a href="#niceng112er1.appj">appendix J: excluded studies</a> with reasons for their exclusion.</p></div><p>See also <a href="#niceng112er1.appd">appendix D: study flow diagram</a>.</p></div><div id="niceng112er1.s2.2"><h3>2.2. Summary of included studies</h3><p>A summary of the included studies is shown in tables 1 to 3. Details of the study citation can be found in <a href="#niceng112er1.appf">appendix F: included studies</a>. An overview of the quality assessment of each included study is shown in <a href="#niceng112er1.appg">appendix G: quality assessment of included studies</a>.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng112er1tab1"><a href="/books/NBK611982/table/niceng112er1.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img" rid-ob="figobniceng112er1tab1"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng112er1.tab1"><a href="/books/NBK611982/table/niceng112er1.tab1/?report=objectonly" target="object" rid-ob="figobniceng112er1tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">Summary of included studies: non-pharmacological interventions. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng112er1tab2"><a href="/books/NBK611982/table/niceng112er1.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img" rid-ob="figobniceng112er1tab2"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng112er1.tab2"><a href="/books/NBK611982/table/niceng112er1.tab2/?report=objectonly" target="object" rid-ob="figobniceng112er1tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Summary of included studies: non-antimicrobial pharmacological interventions. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng112er1tab3"><a href="/books/NBK611982/table/niceng112er1.tab3/?report=objectonly" target="object" title="Table 3" class="img_link icnblk_img" rid-ob="figobniceng112er1tab3"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng112er1.tab3"><a href="/books/NBK611982/table/niceng112er1.tab3/?report=objectonly" target="object" rid-ob="figobniceng112er1tab3">Table 3</a></h4><p class="float-caption no_bottom_margin">Summary of included studies: antimicrobials. </p></div></div></div></div><div id="niceng112er1.s3"><h2 id="_niceng112er1_s3_">3. Clinical effectiveness</h2><p>Full details of clinical effectiveness are shown in <a href="#niceng112er1.apph">appendix H: GRADE profiles</a>. The main results are summarised below.</p><div id="niceng112er1.s3.1"><h3>3.1. Non-pharmacological interventions</h3><div id="niceng112er1.s3.1.1"><h4>3.1.1. Lactobacillus (probiotic) in non-pregnant women</h4><p>The evidence review for lactobacillus is based on 2 meta-analyses (<a class="bibr" href="#niceng112er1.appf.ref5" rid="niceng112er1.appf.ref5">Grin et al. 2013</a> and <a class="bibr" href="#niceng112er1.appf.ref12" rid="niceng112er1.appf.ref12">Schwenger et al. 2015</a>). The studies cover lactobacillus compared with placebo, and lactobacillus compared with antibiotics.</p><div id="niceng112er1.s3.1.1.1"><h5>Lactobacillus versus placebo</h5><p>The evidence review for lactobacillus versus placebo is based on <a class="bibr" href="#niceng112er1.appf.ref5" rid="niceng112er1.appf.ref5">Grin et al. 2013</a> (5 RCTs, n=294), which included studies in premenopausal women with a history of prior urinary tract infection (UTI) (defined as 1 or more UTIs within the last 12 months prior to entry to the study). In 2 studies included in the meta-analysis, participants received a course of lactobacillus following a UTI treated with antimicrobials until the infection cleared. Four studies treated the women with vaginal pessaries containing lactobacillus, the remaining study used a lactobacillus drink preparation. The strains of <i>Lactobacillus spp.</i> included across the studies were: <i>L. rhamnosus</i> GR-1, <i>L. fermentum</i> B-54, <i>L. casei v rhamnosus</i> LCR35, <i>L. rhamnosus</i> GG, and <i>L. crispastus</i> CTV-05. The composition of the different preparations varied among the different studies. The pessaries were administered daily, 5 days a week or twice a week. The length of treatment ranged from 5 days to 12 months. Length of follow-up was also inconsistent between studies, ranging from 4 weeks to 12 months.</p><p>The populations included in the studies were mostly premenopausal adult women. Only 1 study reported the age range of included participants; their ages ranged from 18 to 50 years old. Most studies included in the meta-analysis defined UTI with microbiological criteria that ranged from 10<sup>3</sup> colony forming units per millilitre (CFU/mL) to 10<sup>5</sup> CFU/mL. In some studies, women were already receiving antibiotic treatment for their UTI and, in 1 study the women were healthy and had no infection.</p><p><i>Lactobacillus spp</i>. did not significantly reduce the risk of recurrent UTIs in premenopausal women when compared with placebo (5 RCTs, n=194: 29.9% versus 34.7%; risk ratio [RR] 0.85 95% CI 0.58 to 1.25; low quality evidence). When authors restricted the analysis to studies that only used ‘effective strains’ of lactobacillus (as defined by the authors), results were statistically significant (2 RCTs, n=127, 16.1% versus 32.3%: RR 0.51, 95% CI 0.26 to 0.99; NNT 7 [95% CI 4 to 64]; moderate quality evidence).</p></div><div id="niceng112er1.s3.1.1.2"><h5>Lactobacillus versus antibiotics</h5><p>The evidence review for lactobacillus versus antibiotics is based on a single RCT (<a href="https://www.ncbi.nlm.nih.gov/pubmed/16566424" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NAPRUTI Study II 2006</a>) reported within a systematic review (<a class="bibr" href="#niceng112er1.appf.ref12" rid="niceng112er1.appf.ref12">Schwenger et al. 2015</a>). The ‘Non-antibiotic versus Antibiotic Prophylaxis for Recurrent Urinary Tract Infections’ (NAPRUTI) study compared <i>Lactobacillus spp.</i> (<i>L. rhamnosus</i> GR-1 and <i>L. reuteri</i> RC-14) with co-trimoxazole as prophylaxis for the prevention of UTIs in postmenopausal women with recurrent UTIs. Patients randomised to receive lactobacillus took 1 capsule containing at least 10<sup>9</sup> CFUs of <i>L. rhamnosus GR-1</i> and <i>L. reuteri RC-14</i> twice a day and 1 placebo capsule at night for 12 months. Patients randomised to receive co-trimoxazole took a 480 mg tablet at night, and 1 placebo capsule twice a day for 12 months.</p><p><a class="bibr" href="#niceng112er1.appf.ref12" rid="niceng112er1.appf.ref12">Schwenger et al. (2015)</a> defined the rate of UTIs in each treatment group as the number of patients experiencing at least 1 UTI, not the number of UTIs in a treatment group.</p><p>There was no significant difference in the number of symptomatic infections between women treated with lactobacillus and those treated with antibiotics (1 RCT, n=223: 74.8% versus 66.7%; RR 1.12, 95% CI 0.95 to 1.33; low quality evidence).</p><p>Sensitivity analysis was conducted to determine the effect of imputing data (participants with missing data were assumed to have negative outcomes, known as worst case scenario), or ignoring missing data on the reported outcome. When a worst case scenario was applied for those randomised to the lactobacillus treatment group, there was a significant increase in the number of symptomatic bacterial UTIs seen in this group compared with those receiving antibiotics (1 RCT, n=223: 79.1% versus 66.7%; RR 1.19 95% CI 1.01 to 1.4; NNT 8 [95% CI 5 to 114]; moderate quality evidence). However, when a worst case scenario was applied for antibiotics, there was a significant increase in the number of symptomatic bacterial UTIs seen in this group compared with those receiving lactobacillus (1 RCT, n=223: 74.8% versus 89.8%; RR 0.83 95% CI 0.74 to 0.94; NNT 7 [95% CI 4.0 to 19.0]; moderate quality evidence).</p></div></div><div id="niceng112er1.s3.1.2"><h4>3.1.2. D-Mannose in non-pregnant women</h4><p>The evidence review for D-mannose is based on 1 RCT (<a class="bibr" href="#niceng112er1.appf.ref7" rid="niceng112er1.appf.ref7">Kranjcec et al. 2014</a>, n=308) comparing D-mannose (200 ml of 1% solution once daily in the evening) with no treatment, or an antibiotic (nitrofurantoin 50 mg once daily in the evening). <a class="bibr" href="#niceng112er1.appf.ref7" rid="niceng112er1.appf.ref7">Kranjcec et al. (2014)</a> included non-pregnant women who presented with current UTI and a history of recurrent UTI. The authors defined the latter as 2 episodes in the last 6 months or 3 episodes in the last year. Authors based the diagnosis of UTI on a microbiological assessment (≥10<sup>3</sup> CFUs per ml) as well as lower urinary tract symptoms such as dysuria, frequency and urgency. All women in the study took antibiotics (ciprofloxacin 500 mg twice a day) for 1 week for their current UTI. The median age was between 48 and 52 years, and 47.4% of participants were postmenopausal. The authors assessed effectiveness as the number of participants presenting with 1 recurrent UTI during the study period.</p><div id="niceng112er1.s3.1.2.1"><h5>D-mannose versus no treatment</h5><p>D-mannose was significantly more effective in preventing recurrent UTI in non-pregnant women compared with no treatment over the 6-month study period (<a class="bibr" href="#niceng112er1.appf.ref7" rid="niceng112er1.appf.ref7">Kranjcec et al. 2014</a>, n=205: 14.6% versus 60.8%; RR 0.24, 95% CI 0.15 to 0.39; NNT 3 [95% CI 2 to 3]; high quality evidence).</p></div><div id="niceng112er1.s3.1.2.2"><h5>D-mannose versus antibiotic</h5><p>D-mannose did not show a significant benefit in reducing recurrent UTIs in non-pregnant women when compared with antibiotics (nitrofurantoin 50 mg a day) over the 6-month study period (<a class="bibr" href="#niceng112er1.appf.ref7" rid="niceng112er1.appf.ref7">Kranjcec et al. 2014</a>, n=206: 14.6% versus 20.4%; RR 0.71, 95% CI not stated, calculated by NICE as 95% CI 0.39 to 1.31; low quality evidence).</p></div></div><div id="niceng112er1.s3.1.3"><h4>3.1.3. Cranberry products</h4><p>The evidence review for cranberry products is based on 1 <a href="https://www.nice.org.uk/Glossary?letter=S" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">systematic review</a> (<a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. 2012</a>,) and 2 RCTs (<a class="bibr" href="#niceng112er1.appf.ref2" rid="niceng112er1.appf.ref2">Beerepoot et al. 2011</a> and <a class="bibr" href="#niceng112er1.appf.ref13" rid="niceng112er1.appf.ref13">Uberos et al. 2012</a>). The 2 RCTs provided evidence on antimicrobial resistance (see <a href="#niceng112er1.s5">section 5</a>). Across all publications included, authors defined recurrent UTI as 3 episodes of infection in the last 12 months or 2 episodes of infection in the last 6 months. Participants received cranberry products either in liquid form (juice or syrup) or solid form (capsules or tablets). Cranberry products were compared with placebo, no treatment or antibiotics.</p><div id="niceng112er1.box2" class="box boxed-text-box whole_rhythm hide-overflow"><p>Two further systematic reviews were identified following stakeholder consultation and an updated search. <a class="bibr" href="#niceng112er1.appf.ref4" rid="niceng112er1.appf.ref4">Fu et al. (2017)</a> conducted a meta-analysis comparing cranberry products with placebo or no treatment in non-pregnant women and <a class="bibr" href="#niceng112er1.appf.ref10" rid="niceng112er1.appf.ref10">Roshdibonab et al. (2017)</a> conducted the same comparison in children.</p></div><div id="niceng112er1.s3.1.3.1"><h5>Cranberry products in women</h5><p>Two systematic reviews (<a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. 2012</a> and <a class="bibr" href="#niceng112er1.appf.ref4" rid="niceng112er1.appf.ref4">Fu et al. 2017</a>) and 1 RCT (<a class="bibr" href="#niceng112er1.appf.ref2" rid="niceng112er1.appf.ref2">Beerepoot et al. 2011</a>) assessed the efficacy of cranberry products for preventing UTIs in women. The studies included women with recurrent or previous UTI. Age groups varied across the studies from young women to elderly women and not all studies specified whether pregnant women were excluded. The main outcome of interest was reduction of recurrent UTIs, defined as participants with 1 or more UTI, or repeat symptomatic UTI.</p><div id="niceng112er1.s3.1.3.1.1"><h5>Cranberry products versus placebo or no treatment</h5><p><a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. (2012)</a> identified 4 RCTs that compared cranberry products (juice, syrup or tablets) with matched placebo or no treatment. The concentration of cranberry products as well as the frequency of administration varied across the studies. The age of women also varied across the studies from 21 to 72 years. Across the studies, authors used microbiological criteria and symptoms to assess UTIs. Some studies required >104 CFUs/ml in a sample, and others ≥10<sup>5</sup> CFUs/ml in a sample.</p><p><a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. 2012</a> found that prophylactic cranberry products for 3, 6 or 12 months did not show a significant benefit in the number of women who had one or more UTI during follow up (4 RCTs, n=594: 19.9% versus 22.8%; RR 0.74, 95% CI 0.42 to 1.31; very low quality evidence) when compared with placebo or no treatment.</p><div id="niceng112er1.box3" class="box boxed-text-box whole_rhythm hide-overflow"><h3><span class="title">Evidence identified following stakeholder consultation</span></h3><p><a class="bibr" href="#niceng112er1.appf.ref4" rid="niceng112er1.appf.ref4">Fu et al. (2017)</a> compared cranberry in either juice or capsule form, for preventing UTIs in non-pregnant women, with a follow up of 6 to 12 months. Age of participants varied from 21 to 72 years old. The included studies differed in their definition of UTI, with most trials defining UTI through the presence of symptoms, and 4 requiring confirmed bacteriuria of varying thresholds. This data adds an additional 4 unique RCTs to the <a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. (2012)</a> analysis, including a total of 501 additional participants. Furthermore, 3 of the RCTs included in <a class="bibr" href="#niceng112er1.appf.ref4" rid="niceng112er1.appf.ref4">Fu et al. (2017)</a>, are also included in <a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. (2012)</a>, while 1 RCT included in <a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. (2012)</a> is not included in <a class="bibr" href="#niceng112er1.appf.ref4" rid="niceng112er1.appf.ref4">Fu et al. (2017)</a>.</p><p>Cranberry juice or capsules significantly reduced the incidence of UTI in non-pregnant women, diagnosed either by symptom presence or culture confirmation, compared with placebo or no treatment (7 RCTs, n=1498: 20.7% versus 26.5%; RR 0.74, 95% CI 0.55 to 0.98; very low quality evidence). When restricted to UTIs confirmed by culture, this difference was not significantly significant (5 RCTs, n=912: 19.8% versus 24.0%; RR 0.71, 95% CI 0.45 to 1.12; very low quality evidence).</p><p>Cranberry juice did not significantly reduce the incidence of UTI, diagnosed either by symptom presence or culture confirmation, compared with placebo or no treatment (6 RCTs, n= 1272: 22.0% versus 26.6%; RR 0.79, 95% CI 0.59 1.06, very low quality evidence). However, cranberry tablets did significantly reduce incidence of UTI compared with placebo (2 RCTs, n= 276: 13.5% versus 28.0%; RR 0.48, 95% CI 0.29 to 0.79; low quality evidence).</p></div></div><div id="niceng112er1.s3.1.3.1.2"><h5>Cranberry products versus antibiotics</h5><p><a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. 2012</a> identified 2 RCTs that compared cranberry products (tablets 500 mg) with antibiotics (trimethoprim 100 mg or co-trimoxazole 480 mg). The frequency of administration varied across the studies. The age of women varied across the studies, with 1 study recruiting women aged 45 years and older, and the other study including premenopausal women who were older than 18 years. It was unclear whether pregnant women were excluded. Both RCTs used microbiologic criteria to confirm UTIs. One study required >10<sup>4</sup> CFUs/ml in a urine sample while the other required ≥10<sup>5</sup> CFUs/ml. The duration of the studies was 6 or 12 months.</p><p>Prophylactic cranberry products did not show a significant benefit in reducing recurrent UTIs in women (2 RCTs, n=344: 51.1% versus 40.4%; RR 1.31, 95% CI 0.85 to 2.02; moderate quality evidence) when compared with antibiotics (trimethoprim or co-trimoxazole).</p></div></div><div id="niceng112er1.s3.1.3.2"><h5>Cranberry products versus placebo or no treatment in pregnant women</h5><p>One systematic review (<a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. 2012</a>) assessed the efficacy of cranberry products for preventing UTIs pregnant women, which included 2 studies of cranberry products (juice) compared with matched placebo or water. No data were identified for comparisons with antibiotics. The authors did not provide details on whether pregnant women had previous or current UTIs. One study was available as abstract only and did not include information on diagnosis of UTI or treatment length. The authors of the second study confirmed UTI using microbiological criteria (>10<sup>8</sup> CFUs per ml of single organism) and symptoms such as dysuria, frequency or urgency. The length of this study was 5 to 7 months. The main outcome reported was the reduction of recurrent UTIs, defined as participants with 1 or more UTI, or repeat symptomatic UTI.</p><p>Prophylactic cranberry products did not show a significant benefit in reducing recurrent UTIs in pregnant women (<a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. 2012</a>, 2 RCTs, n=674: 56.6% versus 55.6%; RR 1.04, 95% CI 0.93 to 1.17; moderate quality evidence) when compared with placebo or no treatment. No other relevant outcomes were reported.</p></div><div id="niceng112er1.s3.1.3.3"><h5>Cranberry products versus placebo or no treatment in elderly men and women</h5><p>One systematic review (<a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. 2012</a>) assessed the efficacy of cranberry products for preventing UTIs in older people (men and women), which included 2 RCTs. These RCTs covered whether cranberry products (juice or capsules) were more effective than matched placebo or no treatment in adults aged 60 years and over. In 1 study, patients took 300 ml cranberry juice or matched placebo juice. It was unclear whether this was taken once a day or more frequently. In the other study patients took a 650 mg cranberry capsule once or twice a day. The studies included people who were either admitted to acute medicine for the elderly assessment, rehabilitation units for elderly people, or lived in care facilities. One study only included elderly people with dementia. Both RCTs used microbiologic criteria and symptoms to confirm UTI. One study required >10<sup>4</sup> CFUs/ml in a urine sample while the other required ≥10<sup>8</sup> CFUs/ml. No data were identified for comparisons with antibiotics. The main outcome reported was participants with 1 or more UTI at follow up, measured using urine culture.</p><p>Prophylactic cranberry products did not show a significant benefit in reducing recurrent UTIs in older people (men and women) when compared with placebo or no treatment during a 6-month treatment period (2 RCTs, n=413: 9.7% versus 12.6%; RR 0.75, 95% CI 0.39 to 1.44; very low quality evidence).</p></div><div id="niceng112er1.s3.1.3.4"><h5>Cranberry products in children</h5><p>Two systematic reviews (<a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. 2012</a> and <a class="bibr" href="#niceng112er1.appf.ref10" rid="niceng112er1.appf.ref10">Roshdibonab et al. 2017</a>) assessed the efficacy of cranberry products for preventing UTIs in children. The included studies covered whether cranberry products were more effective than placebo or no treatment, or antibiotics. The main outcome reported was reduction of recurrent UTI defined as participants with 1 or more UTI or repeated symptomatic UTI.</p><div id="niceng112er1.s3.1.3.4.1"><h5>Cranberry products versus placebo or no treatment</h5><p><a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. (2012)</a> identified 2 RCTs comparing cranberry products (concentrate or juice) with matched placebo or no treatment. One publication included only girls aged 3 to 14 years with an average age of 7 years and 6 months. The other publication did not specify the sex or ages of the children. The authors of 1 publication used symptoms and microbiological criteria (> 10<sup>8</sup> CFUs per ml) to diagnose UTI, whereas the other publication did not specify diagnostic criteria.</p><p>Prophylactic cranberry products did not show a significant benefit in reducing recurrent UTIs in children over the 6-month study period (2 RCTs, n=309: 16.3% versus 29.5%; RR 0.48, 95% CI 0.19 to 1.22; low quality evidence) when compared with placebo or no treatment.</p><div id="niceng112er1.box4" class="box boxed-text-box whole_rhythm hide-overflow"><h3><span class="title">Evidence identified following stakeholder consultation</span></h3><p><a class="bibr" href="#niceng112er1.appf.ref10" rid="niceng112er1.appf.ref10">Roshdibonab et al. (2017)</a> included 8 RCTs comparing cranberry taken daily in juice or capsule form, with placebo for recurrent UTI in children, with 2 to 12 month follow up. Children were aged between 1 to 13 years, with UTI diagnosed by positive urine culture in all studies. Two of the RCTs included in the meta-analysis included children with catheters. This data includes an additional 6 RCTs to the <a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. (2012)</a> analysis, including a total of 262 additional participants. The 2 RCTs included in <a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. (2012)</a> for this population are also included in <a class="bibr" href="#niceng112er1.appf.ref10" rid="niceng112er1.appf.ref10">Roshdibonab et al. (2017)</a>.</p><p>Children using cranberry juice or capsules showed a significant reduction in incidence of culture confirmed UTI compared with children taking placebo (8 RCTs, n= 571: OR 0.31, 95% CI 0.21 to 0.46; very low quality evidence).</p></div></div><div id="niceng112er1.s3.1.3.4.2"><h5>Cranberry products versus antibiotics</h5><p><a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. (2012)</a> identified 1 RCT comparing cranberry products (syrup) with antibiotics (trimethoprim 8 mg/kg). The authors included children between 1 month and 13 years, and mean ages ranged from 28.3 to 30.7 months. Children either presented with recurrent UTI (2 or more infections in 6 months), vesicoureteric reflux of any degree, pyelic ectasia or hydronephrosis, or anatomical kidney disorder.</p><p><a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. 2012</a> found that prophylactic cranberry products did not show a significant benefit in reducing recurrent UTIs in children (1 RCT, n=192: 10.7% versus 15.4%; RR 0.69, 95% CI 0.32 to 1.51; low quality evidence) when compared with antibiotics (trimethoprim) over the 6-month study period.</p></div></div></div></div><div id="niceng112er1.s3.2"><h3>3.2. Non-antimicrobial pharmacological interventions</h3><div id="niceng112er1.s3.2.1"><h4>3.2.1. Oestrogens in post-menopausal women</h4><p>The evidence review for oestrogens (with or without progestogens) is based on 1 systematic review of 9 RCTs (<a class="bibr" href="#niceng112er1.appf.ref9" rid="niceng112er1.appf.ref9">Perrotta et al. 2008</a>, n=3,345). The author’s objective was to examine the efficacy of oestrogen in decreasing the rate of recurrent urinary tract infection (UTI) in postmenopausal women and its safety. All studies within the systematic review included post-menopausal women with recurrent UTI (defined as 3 episodes of infection in the last 12 months or 2 episodes of infection in the last 6 months). The systematic review included comparisons of oral oestrogen versus placebo, vaginal oestrogen versus placebo, and vaginal oestrogen versus oral antibiotics. The main efficacy outcome was reduction in recurrent UTI.</p><div id="niceng112er1.s3.2.1.1"><h5>Oral oestrogens compared with placebo</h5><p><a class="bibr" href="#niceng112er1.appf.ref9" rid="niceng112er1.appf.ref9">Perrotta et al. (2008)</a> identified 4 RCTs that reported on the efficacy of oral oestrogens compared with placebo in post-menopausal women. These included 1 large study (n=2,654) with a duration of up to 4 years, and 3 smaller studies (fewer than 100 participants each) with durations of 12 weeks or 6 months. The age of women varied across the studies, with the large study recruiting participants less than 80 years of age, while another study reported mean age of 88 years. In the large study the oestrogen preparation also contained a progestogen. There was no significant reduction in recurrent UTI when oral oestrogen was compared with placebo (4 RCTs, n=2,798: 11.3% versus 10.4%; RR 1.08, 95% CI 0.88 to 1.33; moderate quality evidence).</p></div><div id="niceng112er1.s3.2.1.2"><h5>Vaginal oestrogens compared with placebo or no treatment</h5><p><a class="bibr" href="#niceng112er1.appf.ref9" rid="niceng112er1.appf.ref9">Perrotta et al. (2008)</a> identified 2 small RCTs that reported on the efficacy of vaginal oestrogens compared with placebo or no treatment. The trials differed in the administration method of oestrogens and comparator used. One RCT compared an oestrogen-releasing vaginal ring with no treatment while the other compared topically applied vaginal oestrogen cream with placebo cream. The age of the participants was not reported, and the results were presented separately for each study, not pooled in a meta-analysis. Oestrogen administered via a vaginal ring (Estring) showed a statistically significant benefit for reducing recurrent UTI compared with no treatment during the 36 week study period (1 RCT, n=108: 50.9% versus 80%; RR 0.64, 95% CI 0.47 to 0.86; NNT 4 [95% CI 3 to 9]; moderate quality evidence). Similarly, oestrogen administered topically (oestriol cream) showed a significant reduction in recurrent UTI when compared with placebo during an 8-month study period (1 RCT, n=93: 16% versus 62.8%; RR 0.25 95% CI 0.13 to 0.5; NNT 3 [95% CI 2 to 4]; high quality evidence).</p></div><div id="niceng112er1.s3.2.1.3"><h5>Vaginal oestrogens versus antibiotics</h5><p><a class="bibr" href="#niceng112er1.appf.ref9" rid="niceng112er1.appf.ref9">Perrotta et al. (2008)</a> identified 2 RCTs that reported on the efficacy of vaginal oestrogens (pessary or cream) compared with oral antibiotics (nitrofurantoin or ofloxacin). Both studies included post-menopausal women. However, ages or diagnostic criteria for UTI were not specified. <a class="bibr" href="#niceng112er1.appf.ref9" rid="niceng112er1.appf.ref9">Perrotta et al. (2008)</a> presented the results of the studies separately as the authors felt that results could not be pooled due to high heterogeneity. There were significantly more UTIs at the end of the 9-month study period with vaginal oestrogens delivered via pessary compared with nitrofurantoin 100 mg a day (1 RCT, n=171; 67.4% versus 51.8%; RR 1.3, 95% CI 1.01 to 1.68; low quality evidence). In contrast, vaginal oestrogen cream (premarin cream) was significantly more effective than ofloxacin 600 mg a day in reducing recurrent UTI at the end of the 3-month study period (1 RCT, n=42; 7.4% versus 80%; RR 0.09 95% CI 0.02 to 0.36; NNT 2 [95% CI 2 to 2]; low quality evidence). This benefit only lasted as long as participants were on prophylaxis, with no benefit seen 2 months after stopping (1 RCT, n=42; 7.4% versus 13.3%; RR 0.56 95% CI 0.09 to 3.55; very low quality evidence).</p></div></div></div><div id="niceng112er1.s3.3"><h3>3.3. Antimicrobials in non-pregnant women</h3><p>The evidence review for antimicrobials in non-pregnant women is based on 1 systematic review (<a class="bibr" href="#niceng112er1.appf.ref1" rid="niceng112er1.appf.ref1">Albert et al. 2004</a>), and 1 RCT (<a class="bibr" href="#niceng112er1.appf.ref15" rid="niceng112er1.appf.ref15">Zhong et al. 2011</a>). The included studies assessed antibiotics compared with placebo, and the duration of antibiotic treatment.</p><div id="niceng112er1.s3.3.1"><h4>3.3.1. Antibiotics compared with placebo</h4><p><a class="bibr" href="#niceng112er1.appf.ref1" rid="niceng112er1.appf.ref1">Albert et al. (2004)</a> included 10 RCTs comparing antibiotics with placebo (n=1,120), assessing the efficacy and safety of antibiotic prophylaxis to prevent recurrent urinary tract infection (UTI) in adult non-pregnant women. Participants were included if they had experienced at least 2 episodes of uncomplicated UTI in the previous year, and were aged over 14 years old. The authors performed sensitivity analysis, excluding trials that had different inclusion criteria or tested different prophylaxis schedules.</p><p>In 8 RCTs, antibiotic prophylaxis was given for 6 months, and in 2 RCTs it was given for 12 months. The antibiotic dose regimens used in the studies included: ciprofloxacin 125 mg post-coital (women were instructed to take ciprofloxacin as a single dose after sexual intercourse), co-trimoxazole 40/200 mg daily, cephalexin 125 mg daily, nitrofurantoin 50 mg daily, nitrofurantoin 100 mg daily, norfloxacin 200 mg daily and cinoxacin 250 mg daily). In all studies, prophylaxis was stopped in each case of recurrent infection. Recurrence was defined as the presence of bacteriuria and the clinical symptoms of UTI.</p><p>Antibiotic prophylaxis, when compared with placebo, significantly reduced the recurrence of UTI during the prophylactic period of 6 to 12 months, when using microbiological criteria (10 RCTs, n=372: 12.3% versus 65.5%; RR 0.21 95% CI 0.13 to 0.34; NNT 2 [95% CI 2 to 3]; high quality evidence) and clinical criteria (7 RCTs, n=257: 7.4% versus 51.2%; RR 0.15 95% CI 0.08 to 0.28; NNT 3 [95% CI 2 to 3]; high quality evidence). However, this effect was diminished when recurrence was reported after the prophylactic period (2 RCTs, n=70: 52.3% versus 57.7%; RR 0.82 95% CI 0.44 to 1.53; very low quality evidence).</p></div><div id="niceng112er1.s3.3.2"><h4>3.3.2. Choice of antibiotic</h4><p>Although <a class="bibr" href="#niceng112er1.appf.ref1" rid="niceng112er1.appf.ref1">Albert et al. (2004)</a> reported outcomes for studies which compared different antibiotic choices, these studies were included in a larger meta-analysis (<a class="bibr" href="#niceng112er1.appf.ref8" rid="niceng112er1.appf.ref8">Muller et al. 2017</a>), which is described in <a href="#niceng112er1.s3.5.2">section 3.5.2</a> of this evidence review.</p></div><div id="niceng112er1.s3.3.3"><h4>3.3.3. Antibiotic dosing and course length</h4><p><a class="bibr" href="#niceng112er1.appf.ref15" rid="niceng112er1.appf.ref15">Zhong et al. (2011)</a> (n=83) compared the efficacy and safety of intermittent single-dose antibiotic prophylaxis versus continuous antibiotic prophylaxis over 12 months. The study included postmenopausal women who had experienced 3 or more UTIs within a 12-month period. The average number of UTIs prior to entry was approximately 5 infections in the previous year, in both treatment groups. Participants took antibiotics either continuously over the study period or used single-dose antibiotics whenever they were exposed to conditions that might trigger UTI. These conditions were determined from the women’s experience and included working or walking for a long time, sexual intercourse, travelling, or micturition delay. It was unclear whether women took their intermittent antibiotics before or after exposure to triggers for UTI. The choice of antibiotic (nitrofurantoin, norfloxacin, ciprofloxacin, amoxicillin, co-trimoxazole, cefaclor or cefuroxime) in both groups was done on a case by case basis and depended on the woman’s previous use of antibiotics and the outcome of an antimicrobial susceptibility test. Dose varied by antibiotic but was the same for an individual antibiotic. Diagnosis of UTI was based on microscopic pyuria in a urine test.</p><p>The authors reported the number of episodes of UTI per year, the number of episodes per year per patient as well as the number of patients having 1, 2, 3, and up to 12 episodes per year. There was no statistically significant difference between the intermittent single-dose and continuous treatment regimens (<a class="bibr" href="#niceng112er1.appf.ref15" rid="niceng112er1.appf.ref15">Zhong et al. 2011</a>, n=68: 80.6% versus 70.3%; RR and 95% CI not stated; calculated by NICE as RR 1.15 95% CI 0.87 to 1.51; moderate quality evidence).</p><p>One study in <a class="bibr" href="#niceng112er1.appf.ref1" rid="niceng112er1.appf.ref1">Albert et al. 2004</a> (Melekos et al. 1997), compared ciprofloxacin 125 mg taken as a single dose immediately after sexual intercourse, and ciprofloxacin taken as a single dose at night. The study was conducted in pre-menopausal women aged 18 to 45, who were sexually active and had ≥3 documented lower UTIs in the last 12 months. They found no significant difference in the number of women experiencing at least one microbiological recurrence whilst on prophylaxis (1 RCT, n=135: 2.9% versus 3.1%; RR 0.93 95% CI 0.13 to 6.4; low quality evidence), or the number of women experiencing at least one clinical recurrence whilst on prophylaxis (1 RCT, n=135: 5.7% versus 4.6%; RR 1.24 95% CI 0.29 to 5.32; low quality evidence). Authors noted no significant difference between groups, in the microbiological recurrence after the prophylactic period (low quality evidence).</p></div></div><div id="niceng112er1.s3.4"><h3>3.4. Antimicrobials in pregnant women</h3><p>The evidence review for antimicrobials in pregnant women is based on 1 systematic review (<a class="bibr" href="#niceng112er1.appf.ref11" rid="niceng112er1.appf.ref11">Schneeberger et al. 2015</a>). This review covers whether antibiotics are more effective than clinical surveillance alone (no treatment) in preventing recurrent urinary tract infection (UTI). <a class="bibr" href="#niceng112er1.appf.ref11" rid="niceng112er1.appf.ref11">Schneeberger et al. (2015)</a> planned to assess the effectiveness of pharmacological and non-pharmacological interventions for the prevention of recurrent UTI in pregnant women. However, only a single RCT was identified as meeting the inclusion criteria, which compared a continuous course of nitrofurantoin and close monitoring until delivery, with close monitoring alone.</p><div id="niceng112er1.s3.4.1"><h4>3.4.1. Nitrofurantoin compared with no treatment (monitoring alone)</h4><p>Pregnant women who were admitted to hospital with a clinical diagnosis of acute pyelonephritis were included into the study. Clinical diagnosis included the presence of costovertebral angle and 2 of the following symptoms: temperature ≥101°F, pyuria, or bacteriuria (>10<sup>3</sup> gram-negative organisms per ml). Women randomised to receive antibiotics were given nitrofurantoin 50 mg three times a day for the remainder of the pregnancy in conjunction with close monitoring. Monitoring was defined as fortnightly visits to the clinic until the 36<sup>th</sup> week of pregnancy, after which time they were seen weekly until delivery. Urine tests were also conducted at each visit.</p><p>Nitrofurantoin significantly reduced the incidence of asymptomatic bacteriuria in pregnant women when compared with monitoring alone (1 RCT, n=102: 32.6% versus 59.3%; RR 0.55 0.95% CI 0.34 to 0.89; NNT 4 [95% CI 3 to 13]; moderate quality evidence). However, nitrofurantoin did not significantly reduce recurrent pyelonephritis (n=167: 7.3% versus 8.2%; RR 0.89, 95% CI 0.31 to 2.53; low quality evidence) or recurrent UTI (n=167: 2.4% versus 8.2%; RR 0.3, 95% CI 0.06 to 1.38; low quality evidence) in pregnant women. Furthermore, nitrofurantoin did not show any additional benefit compared with monitoring alone for the following outcomes: number of preterm births <37 weeks, birthweight, 5 minute Apgar score <7, and miscarriage (very low to low quality evidence).</p></div><div id="niceng112er1.s3.4.2"><h4>3.4.2. Choice of antibiotic</h4><p>No evidence from systematic reviews or RCTs was identified.</p></div><div id="niceng112er1.s3.4.3"><h4>3.4.3. Antibiotic dosing and course length</h4><p>No evidence from systematic reviews or RCTs was identified.</p></div></div><div id="niceng112er1.s3.5"><h3>3.5. Antimicrobials in adults and children (mixed population analysis)</h3><p>The evidence review for antimicrobials in men, women and children is based on 1 systematic review (<a class="bibr" href="#niceng112er1.appf.ref8" rid="niceng112er1.appf.ref8">Muller et al. 2017</a>). This study did not stratify analysis by gender or age, but reported overall outcomes. Most studies included had a mixed gender population in either adults or children. The included studies cover antibiotics versus placebo and antibiotics versus other antibiotics.</p><div id="niceng112er1.s3.5.1"><h4>3.5.1. Antibiotics compared with placebo</h4><div id="niceng112er1.s3.5.1.1"><h5>Nitrofurantoin versus placebo</h5><p><a class="bibr" href="#niceng112er1.appf.ref8" rid="niceng112er1.appf.ref8">Muller et al. (2017)</a>, which included 26 RCTs (n=3,052), assessed the effectiveness of nitrofurantoin (various doses: 100 mg a day, 100mg twice a day, 100 three times a day, 75 mg a day, 50 mg a day or 50 mg twice a day, 1mg/kg (children aged 2 to 18 years), 1.5 mg/kg (children, age not reported), 2 mg/kg (children aged 2 to 12 years)), given as long-term prophylaxis (defined as greater than 14 days), for the primary or secondary prevention of urinary tract infection (UTI) in men, non-pregnant women (pre- or post-menopausal) and children (predominantly female children). The authors did not define primary or secondary prophylaxis. Most included studies recruited people with recurrent UTI; however, the study specific definition of recurrent UTI was not reported. A few studies conducted in children included children with neurogenic bladder requiring catheterisation. The ages of children included in the individual studies was not reported in all studies, or reported in a consistent manner. The duration of antibiotic prophylaxis varied among studies, and ranged from 5 weeks to 24 months. <a class="bibr" href="#niceng112er1.appf.ref8" rid="niceng112er1.appf.ref8">Muller et al. (2017)</a> also assessed short-term prophylaxis (defined as 3 to 14 days). However, the studies included looked at surgical prophylaxis which is not relevant to this evidence review.</p><p>Nitrofurantoin when given as primary or secondary long-term prophylaxis (for 5 weeks to 24 months) significantly reduced the occurrence of UTI in adults and children compared with placebo or no treatment (8 RCTs, n=491: 22.5% versus 59%; RR 0.38, 95% CI 0.28 to 0.50; NNT 3 [95% CI 3 to 4]; low quality evidence).</p><p>One controlled trial included in <a class="bibr" href="#niceng112er1.appf.ref8" rid="niceng112er1.appf.ref8">Muller et al. (2017)</a> which could not be included in the meta-analysis (due to lack of randomisation) compared nitrofurantoin, methenamine hippurate and no treatment in older men and women. Those who were allocated to receive no treatment received almost twice as many antibiotic courses than any other groups (no results were reported, only described narratively).</p></div></div><div id="niceng112er1.s3.5.2"><h4>3.5.2. Choice of antibiotic</h4><p><a class="bibr" href="#niceng112er1.appf.ref8" rid="niceng112er1.appf.ref8">Muller et al. (2017)</a> assessed the effectiveness of nitrofurantoin compared with a range of other antibiotics (amoxicillin, penicillin, pivmecillinam, cefaclor, cefixime, cinoxacin, norfloxacin, co-trimoxazole, trimethoprim, methenamine hippurate) and stratified the analysis according to antibiotic class. The duration of antibiotic prophylaxis varied among studies, and ranged from 3 months to 24 months.</p><div id="niceng112er1.s3.5.2.1"><h5>Nitrofurantoin compared with other antibiotics (overall)</h5><p>There was no significant difference between nitrofurantoin and other antibiotics in reducing the incidence of recurrent UTI in adults and children (22 RCTs, n=1,319: 23.3% versus 26.1%; RR 0.93, 95% CI 0.69 to 1.26; very low quality evidence).</p></div><div id="niceng112er1.s3.5.2.2"><h5>Nitrofurantoin versus methenamine hippurate</h5><p>Using nitrofurantoin as prophylaxis for the prevention of recurrent UTI significantly reduced the incidence of UTI in adults and children compared with methenamine hippurate (2 RCTs, n=196: 35.8% versus 51.2%; RR 0.60, 95% CI 0.43 to 0.85; NNT 7 [95% CI 4 to 102]; low quality evidence).</p></div><div id="niceng112er1.s3.5.2.3"><h5>Nitrofurantoin versus trimethoprim</h5><p>There was no significant difference between nitrofurantoin and trimethoprim in reducing the incidence of UTI in adults or children (5 RCTs, n=350: 22.5% versus 29.3%; RR 0.81, 95% CI 0.38 to 1.71; very low quality evidence).</p></div><div id="niceng112er1.s3.5.2.4"><h5>Nitrofurantoin versus co-trimoxazole</h5><p>There was no significant difference between nitrofurantoin and co-trimoxazole in reducing the incidence of UTI in adults or children (4 RCTs, n=81: 12% versus 8.9%; RR 1.42, 95% CI 0.17 to 12.0; very low quality evidence).</p></div><div id="niceng112er1.s3.5.2.5"><h5>Nitrofurantoin versus beta-lactam antibiotics</h5><p>There was no significant difference between nitrofurantoin and or beta-lactam antibiotics in reducing the incidence of recurrent UTI in adults and children (5 RCTs, n=249: 16.5% versus 22.4%; RR 0.84, 95% CI 0.49 to 1.44; very low quality evidence).</p></div><div id="niceng112er1.s3.5.2.6"><h5>Nitrofurantoin versus quinolones</h5><p>There was no significant difference between nitrofurantoin and quinolones in reducing the incidence of recurrent UTI in adults and children (3 RCTs, n=186: 29.8% versus 14.7%; RR 2.26, 95% CI 0.73 to 7; very low quality evidence).</p></div></div><div id="niceng112er1.s3.5.3"><h4>3.5.3. Antibiotic dosing and course length</h4><p><a class="bibr" href="#niceng112er1.appf.ref8" rid="niceng112er1.appf.ref8">Muller et al. (2017)</a> conducted a meta-analysis to assess the effect of different nitrofurantoin dosing regimens for long-term prophylaxis in adult participants (100 mg daily, 75 mg daily, 50 mg daily and 50 mg twice daily). The studies used to calculate the effect of dose on the incidence of urinary tract infections were not reported by <a class="bibr" href="#niceng112er1.appf.ref8" rid="niceng112er1.appf.ref8">Muller et al. (2017)</a>, neither were they identifiable from the supplementary material. They reported no significant differences between the different regimens (absolute figures not reported; p=0.08, I<sup>2</sup> =53%; unable to give GRADE quality rating).</p></div></div><div id="niceng112er1.s3.6"><h3>3.6. Antimicrobials in children</h3><p>The evidence review for antimicrobials in children is based on 2 systematic reviews (<a class="bibr" href="#niceng112er1.appf.ref3" rid="niceng112er1.appf.ref3">Dai et al. 2010</a>, and <a class="bibr" href="#niceng112er1.appf.ref14" rid="niceng112er1.appf.ref14">Williams and Craig 2011</a>). The included studies cover antibiotics versus placebo and antibiotics versus other antibiotics. Some studies included a small proportion of children diagnosed with vesicoureteric reflux, but most excluded children with grades 4 and 5, or recruited only those with milder/less symptomatic grades (1–3), which typically resolved in most children without intervention.</p><div id="niceng112er1.s3.6.1"><h4>3.6.1. Antibiotics compared with placebo</h4><p><a class="bibr" href="#niceng112er1.appf.ref14" rid="niceng112er1.appf.ref14">Williams and Craig (2011)</a>, which included 5 RCTs (n=1,069), assessed the efficacy of antibiotic prophylaxis compared with placebo in children with recurrent urinary tract infection (UTI). Not all the included studies had clear inclusion and exclusion criteria, and the authors pointed out that it is likely that children were misclassified in the individual studies due to the poor inclusion criteria, and this may impact upon the generalisability of the overall findings. The ages of children included in the studies varied, with 1 study including children from birth to 18 years, and in other studies no age range was reported. The definition of recurrent UTI was not consistent across the studies. However, 1 of the studies included in the review excluded children with a history of urinary tract infection. The length of prophylaxis also differed between studies, with the majority of children receiving antibiotics for at least 6 months. In 2 studies, the length of prophylaxis was not reported. The antibiotics used were nitrofurantoin (50 mg daily [children weighing >20 kg], 25 mg daily [children weighing <20 kg], and co-trimoxazole [trimethoprim 2 mg/kg/daily and sulfamethoxazole 10 mg/kg/daily]. Studies which had a population of children in which more than 50% were diagnosed with any grade of vesicoureteral reflux were excluded from the systematic review.</p><p>Antibiotic prophylaxis did not significantly reduce the recurrence of symptomatic UTI compared with placebo or no treatment (4 RCTs, n=1,024: 10.5% versus 17.2%; RR 0.75, 95% CI 0.36 to 1.53; very low quality evidence). This did not change when the analysis was restricted to studies that only included children without vesicoureteral reflux (3 RCTs, n=491: 7.3% versus 13.8%; RR 0.56 95% CI 0.15 to 2.12; very low quality evidence). There was no significant difference in the rate of antimicrobial resistance to the prophylactic antibiotic in children who received antibiotics compared with placebo (<a class="bibr" href="#niceng112er1.appf.ref14" rid="niceng112er1.appf.ref14">Williams and Craig 2011</a>, 2 RCTs, n=118: 35.3% versus 16.4%; RR 2.4, 95% CI 0.62 to 9.26; very low quality evidence). Similarly, antibiotics offered no significant benefit over the use of placebo or no treatment in the number of repeat positive cultures obtained in children (very low quality evidence).</p><p>Another systematic review (<a class="bibr" href="#niceng112er1.appf.ref3" rid="niceng112er1.appf.ref3">Dai et al. 2010</a>) also assessed the effect of long-term antibiotic prophylaxis in children (aged less than 18 years old) for the prevention of recurrent UTI. Long-term prophylaxis was defined by the authors as antibiotics given for at least 2 months. Children with or without vesicoureteral reflux of various grades were included in the studies. Six out of 7 studies compared co-trimoxazole with placebo for a duration of 3 to 24 months.</p><p>Antibiotics did not significantly reduce the rate of deteriorated renal scars in children when compared with placebo or no treatment (<a class="bibr" href="#niceng112er1.appf.ref3" rid="niceng112er1.appf.ref3">Dai et al. 2010</a>, 7 RCTs, n=1,093: 2.9% versus 3.5%; RR 0.95 95% CI 0.51 to 1.78; very low quality evidence).</p></div><div id="niceng112er1.s3.6.2"><h4>3.6.2. Choice of antibiotic</h4><p>Williams and Craig (2010) assessed the choice of antibiotics for prophylactic use in the prevention of recurrent UTI in children.</p><div id="niceng112er1.s3.6.2.1"><h5>Nitrofurantoin versus trimethoprim</h5><p>Nitrofurantoin (1 to 1.5 mg/kg daily) significantly reduced the risk of obtaining a repeat positive culture at the end of prophylaxis (6 months) compared with trimethoprim (2–3 mg/kg daily) in children being treated to prevent recurrent UTI (1 RCT, n=60: 20% versus 61.7%; RR 0.3, 95% CI 0.2 to 0.6; NNT 3 [95% CI 2 to 8]; moderate quality evidence).</p></div><div id="niceng112er1.s3.6.2.2"><h5>Nitrofurantoin versus co-trimoxazole</h5><p>Nitrofurantoin (1 to 2 mg/kg daily) significantly reduced the recurrence of symptomatic UTI at 6 months compared with co-trimoxazole (2 mg/kg daily) (1 RCT, n=132: 25.8% versus 45.5%; RR 0.57, 95% CI 0.35 to 0.92; NNT 6 [95% CI 3 to 27]; very low quality evidence).</p></div><div id="niceng112er1.s3.6.2.3"><h5>Nitrofurantoin versus cefixime</h5><p>Nitrofurantoin (1 mg/kg daily) did not reduce the risk of obtaining a repeat positive culture at the end of prophylaxis (6 to 12 months) compared with cefixime (2 mg/kg daily; 1 RCT, n=57: 10% versus 7.4%; risk difference 0.03 95% CI -0.12 to 0.17; moderate quality evidence).</p></div></div><div id="niceng112er1.s3.6.3"><h4>3.6.3. Antibiotic dosing and course length</h4><p>No evidence from systematic reviews or RCTs was identified.</p></div></div></div><div id="niceng112er1.s4"><h2 id="_niceng112er1_s4_">4. Safety and tolerability</h2><p>Details of safety and tolerability outcomes from studies included in the evidence review are shown in <a href="#niceng112er1.apph">appendix H: GRADE profiles</a>. The main results are summarised below.</p><p>See the <a href="https://www.medicines.org.uk/emc/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">summaries of product characteristics</a>, <a href="https://bnf.nice.org.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">British National Formulary</a> (BNF) and <a href="https://bnfc.nice.org.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">BNF for children</a> (BNF-C) for information on contraindications, cautions and adverse effects of individual medicines, and for appropriate use and dosing in specific populations, for example, hepatic impairment, renal impairment, pregnancy and breastfeeding.</p><div id="niceng112er1.s4.1"><h3>4.1. Non-pharmacological interventions</h3><div id="niceng112er1.s4.1.1"><h4>4.1.1. Probiotics (lactobacillus)</h4><p>No safety data were reported for lactobacillus compared with placebo. <a class="bibr" href="#niceng112er1.appf.ref12" rid="niceng112er1.appf.ref12">Schwenger et al. (2015)</a> assessed the effect of probiotic prophylaxis for the prevention of recurrent urinary tract infection (UTI) in adults (men and non-pregnant women) and children compared with antibiotics. Safety data were described in 4 studies included in the review, however they were not pooled in the analysis (justification not provided). A single study (NAPRUTI Study II 2006) compared probiotics with antibiotics, and showed there is no significant difference in the number of adverse events experienced by those who receive antibiotics compared with those who receive probiotics (1 RCT, n=152: 5.6% versus 11.8%; RR and 95% CI not stated; calculated by NICE as RR 0.47, 95% CI 0.20 to 1.12; low quality evidence). In the same study, there is no significant difference between the proportions of participants who experienced at least 1 adverse event having received probiotics compared with those who received antibiotics (1 RCT, n= 152: 52.8% versus 58.3%; RR and 95% CI not stated; calculated by NICE as RR 0.91 95% CI 0.73 to 1.13; low quality evidence). Another study included in the review (Stapleton et al. 2011), reported that a single participant withdrew from treatment in the lactobacillus group due to a lack of efficacy.</p></div><div id="niceng112er1.s4.1.2"><h4>4.1.2. D-Mannose</h4><p><a class="bibr" href="#niceng112er1.appf.ref7" rid="niceng112er1.appf.ref7">Kranjcec et al. (2014)</a> assessed the safety of D-mannose compared with an antibiotic (nitrofurantoin) in non-pregnant women who presented with current UTI and a history of recurrent UTI. While <a class="bibr" href="#niceng112er1.appf.ref7" rid="niceng112er1.appf.ref7">Kranjcec et al. (2014)</a> included a no treatment study arm, no adverse events were reported for these participants.</p><div id="niceng112er1.s4.1.2.1"><h5>D-mannose versus placebo or no treatment</h5><p>No relevant evidence was identified.</p></div><div id="niceng112er1.s4.1.2.2"><h5>D-mannose versus antibiotic</h5><p>D-mannose significantly reduced adverse events, such as diarrhoea, nausea, and vaginal burning, in non-pregnant women when compared with nitrofurantoin (n=206: 7.8% versus 28.2%; RR 0.28, 95% CI 0.13 to 0.57; NNH 5 [95% CI 4 to 10]; high quality evidence).</p></div></div><div id="niceng112er1.s4.1.3"><h4>4.1.3. Cranberry</h4><p><a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. 2012</a> assessed the safety of prophylactic cranberry products (24 RCTs, n=4,473) comparing cranberry products with placebo or no treatment, or antibiotics. The authors pooled safety data (any gastrointestinal effect) across several adult subgroups including women, and elderly women and men. Data on children were not available.</p><div id="niceng112er1.s4.1.3.1"><h5>Cranberry products versus placebo or no treatment</h5><p>Prophylactic cranberry products in comparison with placebo or no treatment did not significantly affect the incidence of any gastrointestinal adverse events (4 RCTs, n=597: 3% versus 3.3%; RR 0.83, 95% CI 0.31 to 2.27; low quality evidence).</p></div><div id="niceng112er1.s4.1.3.2"><h5>Cranberry products versus antibiotics</h5><p>Prophylactic cranberry products in comparison with antibiotics did not significantly affect the incidence of gastrointestinal adverse events (2 RCTs, n=344: 9.6% versus 12.0%; RR 0.78, 95% CI 0.42 to 1.42; low quality evidence).</p></div></div></div><div id="niceng112er1.s4.2"><h3>4.2. Non-antimicrobial pharmacological interventions</h3><div id="niceng112er1.s4.2.1"><h4>4.2.1. Oestrogens</h4><p>Hormone replacement therapy (HRT) increases the risk of venous thromboembolism, stroke, endometrial cancer (reduced by a progestogen), breast cancer, and ovarian cancer; there is an increased risk of coronary heart disease in women who start combined HRT more than 10 years after menopause (<a href="https://www.gov.uk/drug-safety-update/hormone-replacement-therapy-updated-advice" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">MHRA Drug Safety Update, November 2015</a>; <a href="https://bnf.nice.org.uk/treatment-summary/sex-hormones.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">British National Formulary [BNF], December 2017</a>). Before prescribing HRT, health professionals should consider carefully the potential benefits and risks for every woman. The minimum effective dose of HRT should be used for the shortest duration (MHRA Drug Safety Update, November 2015). The endometrial safety of long-term or repeated use of topical vaginal oestrogens is uncertain; treatment should be reviewed at least annually, with special consideration given to any symptoms of endometrial hyperplasia or carcinoma (<a href="https://bnf.nice.org.uk/drug/estriol.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">BNF August 2018</a>).</p><p><a class="bibr" href="#niceng112er1.appf.ref9" rid="niceng112er1.appf.ref9">Perrotta et al. (2008)</a> identified 2 small RCTs that reported on the safety of oral oestrogens compared with placebo. Adverse events reported in these RCTs were breast tenderness or discomfort, or vaginal bleeding or spotting. There were significantly more adverse events with oral oestrogen compared with placebo (<a class="bibr" href="#niceng112er1.appf.ref9" rid="niceng112er1.appf.ref9">Perrotta et al. 2008</a>, 2 RCTs, n=104; 23.5% versus 3.8%; RR 5.11, 95% CI 1.39 to 18.76; NNH 5 [95% CI 3 to 14]; high quality evidence).</p><p><a class="bibr" href="#niceng112er1.appf.ref9" rid="niceng112er1.appf.ref9">Perrotta et al. (2008)</a> also identified 2 RCTs that reported on the safety of vaginal oestrogens compared with placebo. Safety results were reported in 2 ways, as pooled analysis and RCT-based results. Overall, results suggested that vaginal oestrogen was associated with more adverse events (vaginal bleeding, nonphysiologic discharge, vaginal irritation, burning, or itching) when compared with placebo (2 RCTs, n=201: 23.3% versus 5.1%; RR 4.57, 95% CI 1.81 to 11.5; NNH 5 [95% CI 3 to 11]; low quality evidence). Furthermore, there were significantly more adverse events (burning, itching, or vaginal bleeding) with vaginal oestrogen compared with oral antibiotics (<a class="bibr" href="#niceng112er1.appf.ref9" rid="niceng112er1.appf.ref9">Perrotta et al. 2008</a>, 2 RCTs, n=216: 16.4% versus 0%; RR 12.86, 95% CI 1.75 to 94.29; NNH 6 [95% CI 4 to 10]; moderate quality evidence).</p></div></div><div id="niceng112er1.s4.3"><h3>4.3. Antimicrobials</h3><p>Antibiotic-associated diarrhoea is estimated to occur in 2 to 25% of people taking antibiotics, depending on the antibiotic used (<a href="https://cks.nice.org.uk/diarrhoea-antibiotic-associated" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NICE clinical knowledge summary [CKS]: diarrhoea – antibiotic associated</a>).</p><p>About 10% of the general population claim to have a penicillin allergy; this has often been because of a skin rash that occurred during a course of penicillin in childhood. Fewer than 10% of people who think they are allergic to penicillin are truly allergic. Therefore, penicillin allergy can potentially be excluded in 9% of the population. People with a history of immediate hypersensitivity to penicillins may also react to cephalosporins and other beta-lactam antibiotics. The most common side effect with penicillins is diarrhoea, which can also cause antibiotic-associated colitis. Diarrhoea is most common with broad-spectrum penicillins (such as amoxicillin and co-amoxiclav) (<a href="https://bnf.nice.org.uk/treatment-summary/penicillins.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">BNF August 2018</a>).</p><p>Quinolones, including ciprofloxacin, cause arthropathy in the weight-bearing joints of immature animals and are generally not recommended in children or young people who are growing (<a href="https://bnf.nice.org.uk/drug/ciprofloxacin.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">BNF August 2018</a>).</p><p>Nitrofurantoin should be used with caution in those with renal impairment. Adults (especially the elderly) and children on long-term therapy should be monitored for liver function and pulmonary symptoms, with nitrofurantoin discontinued if there is a deterioration in lung function (<a href="https://bnf.nice.org.uk/drug/nitrofurantoin.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">BNF August 2018</a>).</p><p>Trimethoprim has a teratogenic risk in the first trimester of pregnancy (folate antagonist), and manufacturers advise avoidance during pregnancy (<a href="https://bnf.nice.org.uk/drug/trimethoprim.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">BNF August 2018</a>).</p><p>Co-trimoxazole is currently under restriction for use in the UK. It is advised that it should only be used in UTI where there is bacteriological evidence of sensitivity to co-trimoxazole. Co-trimoxazole should be used with caution in those with asthma, or people with blood disorders, GP6D deficiency or infants under 6 weeks (except for treatment or prophylaxis of pneumocystis pneumonia) (<a href="https://bnf.nice.org.uk/drug/co-trimoxazole.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">BNF August 2018</a>).</p><div id="niceng112er1.s4.3.1"><h4>4.3.1. Antibiotics in non-pregnant women</h4><p>A systematic review (<a class="bibr" href="#niceng112er1.appf.ref1" rid="niceng112er1.appf.ref1">Albert et al. 2004</a>) assessed the safety of antibiotic prophylaxis for the prevention of recurrent UTI in non-pregnant women.</p><p>Antibiotic prophylaxis did not significantly increase the incidence of severe side effects compared with placebo (10 RCTs, n=420: 4% versus 2.1%; RR 1.58, 95% CI 0.47 to 5.28; low quality evidence). However, antibiotics did increase the incidence of ‘other side effects’ (defined as non-serious side effects such vagina itching and nausea) compared with placebo (10 RCTs, n=420: 15.1% versus 7.7%; RR 1.78, 95% CI 1.06 to 3.00; NNH 13 [95% CI 7 to 70]; low quality evidence).</p><p>One RCT included in the systematic review (Melekos et al. 1997) found no significant difference in the number of non-serious side effects, between premenopausal women who took ciprofloxacin (125 mg) as a single dose immediately after sexual intercourse, or once daily at night (1 RCT, n=135: 5.7% versus 13.8%; RR 0.41 95% CI 0.13 to 1.28; low quality evidence).</p><p><a class="bibr" href="#niceng112er1.appf.ref15" rid="niceng112er1.appf.ref15">Zhong et al. (2011)</a> (n=83) found that intermittent single-dose antibiotics significantly reduced the incidence of adverse events compared with continuous antibiotics (n=73: 63.6% versus 92.5%; RR and 95% CI not stated; calculated by NICE as RR 0.69 95% CI 0.52 to 0.9; NNH 3 [95% CI 2 to 9]; moderate quality evidence).</p></div><div id="niceng112er1.s4.3.2"><h4>4.3.2. Antibiotics in pregnant women</h4><p>No evidence was identified regarding the safety of antibiotic prophylaxis in pregnant women.</p></div><div id="niceng112er1.s4.3.3"><h4>4.3.3. Antibiotics in adults and children</h4><p><a class="bibr" href="#niceng112er1.appf.ref8" rid="niceng112er1.appf.ref8">Muller et al. (2017)</a> assessed the safety of nitrofurantoin, given as long-term prophylaxis (defined as greater than 14 days) for the primary or secondary prevention of UTI in men, non-pregnant women (pre- or post-menopausal) and children (predominantly female children).</p><p>Overall, the use of nitrofurantoin as prophylaxis (for at least 3 months) for recurrent UTI, significantly increased the risk of experiencing mild (not defined) adverse effects compared with other antibiotics (amoxicillin, penicillin, pivmecillinam, cefaclor, cefixime, cinoxacin, norfloxacin, co-trimoxazole, trimethoprim, or methenamine hippurate) (22 RCTs n=1,205: 30.6% versus 11.7%; RR 2.24 95% CI 1.77 to 2.83; NNH 5 [95% CI 4 to 6]; low quality evidence).</p><p>When specific antibiotics were compared, there were significantly more mild adverse effects with nitrofurantoin compared with beta-lactams (5 RCTs, n=275: 25% versus 12.2%; RR 1.99, 95% CI 1.19 to 3.32; NNH 7 [95% CI 4 to 28]; very low quality evidence); trimethoprim (4 RCTs, n=330: 42% versus 14.6%; RR 2.20 95% CI 1.51 to 3.20; NNH 3 [95% CI 2 to 4]; moderate quality evidence); and methenamine hippurate ( 2 RCTs, n=196: 35.8% versus 7%; RR 4.22, 95% CI 2.06 to 8.67; NNH 3 [95% CI 2 to 6]; moderate quality evidence).</p><p>However, when nitrofurantoin was compared with quinolones or co-trimoxazole, there were no significant differences in the number of mild adverse effects (very low quality evidence).</p></div><div id="niceng112er1.s4.3.4"><h4>4.3.4. Antibiotics in children</h4><p><a class="bibr" href="#niceng112er1.appf.ref14" rid="niceng112er1.appf.ref14">Williams and Craig (2011)</a> assessed the safety of antibiotic prophylaxis in comparison with placebo or no treatment in children with recurrent UTI. Antibiotics did not significantly affect the incidence of adverse events reported (2 RCTs, n=914: 3.8% versus 2.4%; RR 2.31, 95% CI 0.03 to 170.67; very low quality evidence) or the number of withdrawals due to adverse events (2 RCTs, n=576: 1.4% versus 3.5%; RR 0.40, 95% CI 0.13 to 1.26; very low quality evidence).</p><p>Nitrofurantoin significantly reduced the incidence of adverse events compared with trimethoprim (1 RCT, n=60: 25.8% versus 62.1%; RR 0.42, 95% CI 0.21 to 0.81; NNH 2 [95% CI 1 to 8]; low quality evidence).</p><p>Nitrofurantoin significantly increased the incidence of adverse events compared with cefixime (1 RCT, n=120: 61.7% versus 28.3%; risk difference 2.18, 95% CI 1.39 to 3.41; NNH 3 [95% CI 2 to 6]; moderate quality evidence).</p></div></div></div><div id="niceng112er1.s5"><h2 id="_niceng112er1_s5_">5. Antimicrobial resistance</h2><p>The consumption of antimicrobials is a major driver for the development of antibiotic resistance in bacteria, and the 3 major goals of antimicrobial stewardship are to:
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<ul><li class="half_rhythm"><div>optimise therapy for individual patients</div></li><li class="half_rhythm"><div>prevent overuse, misuse and abuse, and</div></li><li class="half_rhythm"><div>minimise development of resistance at patient and community levels.</div></li></ul></p><p>The NICE guideline on <a href="https://www.nice.org.uk/ng15" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">antimicrobial stewardship: systems and processes for effective antimicrobial medicine use</a> (2015) recommends that the risk of antimicrobial resistance for individual patients and the population as a whole should be taken into account when deciding whether or not to prescribe an antimicrobial.</p><p>When antimicrobials are necessary to treat an infection that is not life-threatening, a narrow-spectrum antibiotic should generally be first choice. Indiscriminate use of broad-spectrum antibiotics creates a selective advantage for bacteria resistant even to these ‘last-line’ broad-spectrum agents, and also kills normal commensal flora leaving people susceptible to antibiotic-resistant harmful bacteria such as <i>C. difficile</i>. For infections that are not life-threatening, broad-spectrum antibiotics (for example, co-amoxiclav, quinolones and cephalosporins) need to be reserved for second-choice treatment when narrow-spectrum antibiotics are ineffective (<a href="https://www.gov.uk/government/publications/chief-medical-officer-annual-report-volume-2" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">CMO report 2011</a>).</p><p>The <a href="https://www.gov.uk/government/publications/english-surveillance-programme-antimicrobial-utilisation-and-resistance-espaur-report" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">ESPAUR report 2016</a> reported that antimicrobial consumption declined significantly between 2014 and 2015, with community prescribing from general and dental practice decreasing by more than 6%. Antibiotic prescribing in primary care in 2015 is at the lowest level since 2011, with broad-spectrum antibiotic use (antibiotics that are effective against a wide range of bacteria) continuing to decrease in primary care.</p><div id="niceng112er1.s5.1"><h3>5.1. Antimicrobial resistance in the included studies</h3><div id="niceng112er1.s5.1.1"><h4>5.1.1. Cranberry products</h4><p><a class="bibr" href="#niceng112er1.appf.ref2" rid="niceng112er1.appf.ref2">Beerepoot et al. (2011)</a> (n=221) reported that <i>E. coli</i> isolates from women receiving co-trimoxazole showed antibiotic resistance for amoxicillin, trimethoprim, and co-trimoxazole at 1 month prophylaxis (70% resistance). This reduced at 1 and 3 months after stopping prophylaxis, returning to baseline at 12 months. <i>E. coli</i> isolates from women receiving cranberry products did not show antibiotic resistance. However, prophylactic cranberry products did reduce the development of antibiotic resistance in premenopausal women compared with prophylaxis with co-trimoxazole (moderate quality evidence).</p><p>Uberos et al. 2016 (n=192) found that cranberry products did not show a significant benefit in reducing the development of antibiotic resistance in children (n=192; narrative results reported; moderate quality evidence). This study included an unknown proportion of children with vesicoureteral reflux.</p></div><div id="niceng112er1.s5.1.2"><h4>5.1.2. Antibiotic prophylaxis</h4><p><a class="bibr" href="#niceng112er1.appf.ref8" rid="niceng112er1.appf.ref8">Muller et al. (2017)</a> reported resistance data from 1 RCT (n=15) comparing nitrofurantoin prophylaxis with placebo in children. Weekly urine cultures showed <i>E. coli</i> cultures were replaced over time by resistant strains including <i>Klebsiella</i> and <i>Pseudomonas</i> spp<i>.</i>, in children receiving nitrofurantoin prophylaxis, and this change was not seen in children receiving placebo. However, there were no reports of infection from resistant strains (low quality evidence).</p><p>Another RCT included in the systematic review (n= 130) compared nitrofurantoin and trimethoprim prophylaxis in children. At baseline, 9% (6/67) of children randomised to nitrofurantoin carried nitrofurantoin resistant strains, which decreased to 7% (4/60) during prophylaxis. 8% (5/63) of children randomised to trimethoprim carried trimethoprim resistant strains at baseline, which increased to 47% (28/60) throughout prophylaxis (very low quality evidence).</p></div></div></div><div id="niceng112er1.s6"><h2 id="_niceng112er1_s6_">6. Other considerations</h2><div id="niceng112er1.s6.1"><h3>6.1. Resource impact</h3><div id="niceng112er1.s6.1.1"><h4>6.1.1. Antibiotic prophylaxis</h4><p>Recommended antibiotics (nitrofurantoin, trimethoprim, amoxicillin and cefalexin) are available as generic formulations, but there is currently no generic formulation of pivmecillinam, see <a href="https://www.nhsbsa.nhs.uk/pharmacies-gp-practices-and-appliance-contractors/drug-tariff" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drug Tariff</a> for costs.</p><p>Nitrofurantoin 25mg/5ml oral suspension is more expensive than other oral suspensions, such as trimethoprim 50mg/5ml. The cost of a 300 ml bottle of nitrofurantoin is £446.95 compared with £4.87 for a 100 ml bottle of trimethoprim (<a href="https://www.nhsbsa.nhs.uk/pharmacies-gp-practices-and-appliance-contractors/drug-tariff" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drug Tariff</a>, September 2018).</p></div></div><div id="niceng112er1.s6.2"><h3>6.2. Medicines adherence</h3><p>Medicines adherence may be a problem for some people with medicines that require frequent dosing (for example, some antibiotics) or longer treatment duration (for example, with antibiotic prophylaxis). See the NICE guideline on <a href="https://www.nice.org.uk/guidance/cg76" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">medicines adherence</a>).</p></div><div id="niceng112er1.s6.3"><h3>6.3. Regulatory status</h3><div id="niceng112er1.s6.3.1"><h4>6.3.1. Oestrogens</h4><p>A range of oral and vaginal oestrogens (for example, estradiol), with or without progestogens, are available for use in managing menopausal symptoms and prevention of osteoporosis. See the <a href="https://www.medicines.org.uk/emc/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">summaries of product characteristics</a> for information on licensed indications of individual medicines. None are specifically licensed for preventing recurrent urinary tract infections, so use for this indication would be <a href="https://www.medicines.org.uk/emc/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">off label</a>. The prescriber should follow relevant professional guidance, taking full responsibility for the decision. Informed consent should be obtained and documented. See the General Medical Council's <a href="http://www.gmc-uk.org/guidance/ethical_guidance/14316.asp" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Good practice in prescribing and managing medicines and devices for further information</a>.</p></div><div id="niceng112er1.s6.3.2"><h4>6.3.2. Antibiotics</h4><p>Amoxicillin is not licensed for preventing UTIs, so use for this indication would be <a href="https://www.nice.org.uk/Glossary?letter=O" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">off label</a>. The prescriber should follow relevant professional guidance, taking full responsibility for the decision. Informed consent should be obtained and documented. See the <a href="http://www.gmc-uk.org/guidance/ethical_guidance/14316.asp" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General Medical Council's Good practice in prescribing and managing medicines and devices</a> for further information.</p></div></div></div><div id="niceng112er1.s7"><h2 id="_niceng112er1_s7_">7. Terms used in the guideline</h2><div id="niceng112er1.s7.1"><h3>7.1. Vesicoureteric reflux</h3><p>Vesicoureteric reflux occurs when there is damage to the valve between the bladder and the ureters (tubes which carry urine away from the kidney into the bladder), causing it to no longer working properly. This means that urine may flow backwards, and sometimes reach as far back as the kidneys. This is problematic when the urine is infected with bacteria, as the infection can reach the kidneys, and result in a very severe urinary tract infection otherwise known as acute pyelonephritis, or worse. This is common in children (1 in 100), and can lead to multiple urinary tract infections. Most children with the condition, find that it resolves as they get older without intervention.</p></div></div><div id="appendixesappgroup1"><h2 id="_appendixesappgroup1_">Appendices</h2><div id="niceng112er1.appa"><h3>Appendix A. Evidence Sources</h3><p id="niceng112er1.appa.et1"><a href="/books/NBK611982/bin/niceng112er1-appa-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (123K)</span></p></div><div id="niceng112er1.appb"><h3>Appendix B. Review protocol</h3><p id="niceng112er1.appb.et1"><a href="/books/NBK611982/bin/niceng112er1-appb-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (188K)</span></p></div><div id="niceng112er1.appc"><h3>Appendix C. Literature search strategy</h3><p id="niceng112er1.appc.et1"><a href="/books/NBK611982/bin/niceng112er1-appc-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (213K)</span></p></div><div id="niceng112er1.appd"><h3>Appendix D. Study flow diagram</h3><p id="niceng112er1.appd.et1"><a href="/books/NBK611982/bin/niceng112er1-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (137K)</span></p></div><div id="niceng112er1.appe"><h3>Appendix E. Evidence prioritisation</h3><p id="niceng112er1.appe.et1"><a href="/books/NBK611982/bin/niceng112er1-appe-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (119K)</span></p></div><div id="niceng112er1.appf"><h3>Appendix F. Included studies</h3><ul class="simple-list"><li class="half_rhythm"><p><div class="bk_ref" id="niceng112er1.appf.ref1">Albert
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X, Huertas
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I, Pereiro
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II, Sanfelix
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J, Gosalbes
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V, and Perrota
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C (2004) Antibiotics for preventing recurrent urinary tract infection in non-pregnant women. The Cochrane database of systematic reviews (3), CD001209
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[<a href="/pmc/articles/PMC7032641/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7032641</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/15266443" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15266443</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng112er1.appf.ref2">Beerepoot Marielle
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A. J, ter
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Riet, Gerben, Nys
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Sita, van der
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Wal, Willem
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M, de
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Borgie, Corianne
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A J. M, de
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Reijke, Theo
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M, Prins Jan
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M, Koeijers
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Jeanne, Verbon
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Annelies, Stobberingh
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Ellen, and Geerlings Suzanne
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E (2011) Cranberries vs antibiotics to prevent urinary tract infections: a randomized double-blind noninferiority trial in premenopausal women. Archives of internal medicine
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171(14), 1270–8
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[<a href="https://pubmed.ncbi.nlm.nih.gov/21788542" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21788542</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng112er1.appf.ref3">Dai
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B, Liu
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Y, Jia
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J, and Mei
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C (2010) Long-term antibiotics for the prevention of recurrent urinary tract infection in children: a systematic review and meta-analysis. Archives of disease in childhood
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95(7), 499–508
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[<a href="https://pubmed.ncbi.nlm.nih.gov/20457696" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20457696</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng112er1.appf.ref4">Fu
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Z, Liska
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D, Talan
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D., Chung
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M. Cranberry Reduces the Risk of Urinary Tract Infection Recurrence in Otherwise Healthy Women: A Systematic Review and Meta-Analysis. Journal of Nutrition. 2017; 147(12):2282–2288
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[<a href="https://pubmed.ncbi.nlm.nih.gov/29046404" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29046404</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng112er1.appf.ref5">Grin Peter
|
|
M, Kowalewska Paulina
|
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M, Alhazzan
|
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Waleed, and Fox-Robichaud Alison
|
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E (2013) Lactobacillus for preventing recurrent urinary tract infections in women: meta-analysis. The Canadian journal of urology
|
|
20(1), 6607–14
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23433130" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23433130</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng112er1.appf.ref6">Jepson
|
|
RG, Williams
|
|
G, and Craig
|
|
JC (2012) Cranberries for preventing urinary tract infections. The Cochrane database of systematic reviews
|
|
10, CD001321
|
|
[<a href="/pmc/articles/PMC7027998/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7027998</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23076891" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23076891</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng112er1.appf.ref7">Kranjcec
|
|
Bojana, Papes
|
|
Dino, and Altarac
|
|
Silvio (2014) D-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial. World journal of urology
|
|
32(1), 79–84
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23633128" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23633128</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng112er1.appf.ref8">Muller
|
|
A E, Verhaegh
|
|
E M, Harbarth
|
|
S, Mouton
|
|
J W, and Huttner
|
|
A (2017) Nitrofurantoin's efficacy and safety as prophylaxis for urinary tract infections: a systematic review of the literature and meta-analysis of controlled trials. Clinical microbiology and infection: the official publication of the European Society of Clinical Microbiology and Infectious Diseases, [<a href="https://pubmed.ncbi.nlm.nih.gov/27542332" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27542332</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng112er1.appf.ref9">Perrotta
|
|
C, Aznar
|
|
M, Mejia
|
|
R, Albert
|
|
X, and Ng
|
|
C W (2008) Oestrogens for preventing recurrent urinary tract infection in postmenopausal women. The Cochrane database of systematic reviews (2), CD005131
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/18425910" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18425910</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng112er1.appf.ref10">Roshdibonab
|
|
F, Mohammadbager FazlJoo
|
|
S, Torbati
|
|
M, Mohammadi
|
|
Gh, Asadloo
|
|
M, Noshad
|
|
H. The Role of Cranberry in Preventing Urinary Tract Infection in Children; a Systematic Review and Meta-Analysis. Int J Pediatr
|
|
2017; 5(12): 6457–68. DOI: 10.22038/ijp.2017.27041.2327 [<a href="http://dx.crossref.org/10.22038/ijp.2017.27041.2327" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng112er1.appf.ref11">Schneeberger
|
|
Caroline, Geerlings Suzanne
|
|
E, Middleton
|
|
Philippa, and Crowther Caroline
|
|
A (2015) Interventions for preventing recurrent urinary tract infection during pregnancy. The Cochrane database of systematic reviews
|
|
11, CD009279 [<a href="/pmc/articles/PMC6457953/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6457953</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26221993" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26221993</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng112er1.appf.ref12">Schwenger Erin
|
|
M, Tejani Aaron
|
|
M, and Loewen Peter
|
|
S (2015) Probiotics for preventing urinary tract infections in adults and children. The Cochrane database of systematic reviews (12), CD008772
|
|
[<a href="/pmc/articles/PMC8720415/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8720415</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26695595" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26695595</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng112er1.appf.ref13">Uberos
|
|
J, Nogueras-Ocana
|
|
M, Fernandez-Puentes
|
|
V, Rodriguez-Belmonte
|
|
R, Narbona-Lopez
|
|
E, Molina-Carballo
|
|
A, and Munoz-Hoyos
|
|
A (2012) Cranberry syrup vs trimethoprim in the prophylaxis of recurrent urinary tract infections among children: A controlled trial. Open Access Journal of Clinical Trials
|
|
4, 31–38</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng112er1.appf.ref14">Williams
|
|
G, and Craig
|
|
JC (2011) Long-term antibiotics for preventing recurrent urinary tract infection in children. The Cochrane database of systematic reviews (3), CD001534
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/21412872" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21412872</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng112er1.appf.ref15">Zhong
|
|
Y H, Fang
|
|
Y, Zhou
|
|
J Z, Tang
|
|
Y, Gong
|
|
S M, and Ding
|
|
X Q (2011) Effectiveness and safety of patient initiated single-dose versus continuous low-dose antibiotic prophylaxis for recurrent urinary tract infections in postmenopausal women: a randomized controlled study. The Journal of international medical research
|
|
39(6), 2335–43
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/22289552" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22289552</span></a>]</div></p></li></ul></div><div id="niceng112er1.appg"><h3>Appendix G. Quality assessment of included studies</h3><p id="niceng112er1.appg.et1"><a href="/books/NBK611982/bin/niceng112er1-appg-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">G.1. Lactobacillus</a><span class="small"> (PDF, 105K)</span></p><p id="niceng112er1.appg.et2"><a href="/books/NBK611982/bin/niceng112er1-appg-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">G.2. D-Mannose</a><span class="small"> (PDF, 102K)</span></p><p id="niceng112er1.appg.et3"><a href="/books/NBK611982/bin/niceng112er1-appg-et3.pdf" class="bk_dwnld_icn bk_dwnld_pdf">G.3. Cranberry products</a><span class="small"> (PDF, 132K)</span></p><p id="niceng112er1.appg.et4"><a href="/books/NBK611982/bin/niceng112er1-appg-et4.pdf" class="bk_dwnld_icn bk_dwnld_pdf">G.4. Oestrogens</a><span class="small"> (PDF, 103K)</span></p><p id="niceng112er1.appg.et5"><a href="/books/NBK611982/bin/niceng112er1-appg-et5.pdf" class="bk_dwnld_icn bk_dwnld_pdf">G.5. Antimicrobials in non-pregnant women</a><span class="small"> (PDF, 107K)</span></p><p id="niceng112er1.appg.et6"><a href="/books/NBK611982/bin/niceng112er1-appg-et6.pdf" class="bk_dwnld_icn bk_dwnld_pdf">G.6. Antimicrobials in pregnant women</a><span class="small"> (PDF, 102K)</span></p><p id="niceng112er1.appg.et7"><a href="/books/NBK611982/bin/niceng112er1-appg-et7.pdf" class="bk_dwnld_icn bk_dwnld_pdf">G.7. Antimicrobials in a mixed population of adults and children</a><span class="small"> (PDF, 138K)</span></p><p id="niceng112er1.appg.et8"><a href="/books/NBK611982/bin/niceng112er1-appg-et8.pdf" class="bk_dwnld_icn bk_dwnld_pdf">G.8. Antimicrobials in children</a><span class="small"> (PDF, 126K)</span></p></div><div id="niceng112er1.apph"><h3>Appendix H. GRADE profiles</h3><p id="niceng112er1.apph.et1"><a href="/books/NBK611982/bin/niceng112er1-apph-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">H.1. Lactobacillus</a><span class="small"> (PDF, 174K)</span></p><p id="niceng112er1.apph.et2"><a href="/books/NBK611982/bin/niceng112er1-apph-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">H.2. D-mannose in non-pregnant women</a><span class="small"> (PDF, 162K)</span></p><p id="niceng112er1.apph.et3"><a href="/books/NBK611982/bin/niceng112er1-apph-et3.pdf" class="bk_dwnld_icn bk_dwnld_pdf">H.3. Cranberry products</a><span class="small"> (PDF, 272K)</span></p><p id="niceng112er1.apph.et4"><a href="/books/NBK611982/bin/niceng112er1-apph-et4.pdf" class="bk_dwnld_icn bk_dwnld_pdf">H.4. Oestrogens in post-menopausal women</a><span class="small"> (PDF, 176K)</span></p><p id="niceng112er1.apph.et5"><a href="/books/NBK611982/bin/niceng112er1-apph-et5.pdf" class="bk_dwnld_icn bk_dwnld_pdf">H.5. Antimicrobials in non-pregnant women</a><span class="small"> (PDF, 199K)</span></p><p id="niceng112er1.apph.et6"><a href="/books/NBK611982/bin/niceng112er1-apph-et6.pdf" class="bk_dwnld_icn bk_dwnld_pdf">H.6. Antimicrobials in pregnant women</a><span class="small"> (PDF, 172K)</span></p><p id="niceng112er1.apph.et7"><a href="/books/NBK611982/bin/niceng112er1-apph-et7.pdf" class="bk_dwnld_icn bk_dwnld_pdf">H.7. Antimicrobials in a mixed population of adults and children</a><span class="small"> (PDF, 172K)</span></p><p id="niceng112er1.apph.et8"><a href="/books/NBK611982/bin/niceng112er1-apph-et8.pdf" class="bk_dwnld_icn bk_dwnld_pdf">H.8. Antimicrobials in children</a><span class="small"> (PDF, 202K)</span></p></div><div id="niceng112er1.appi"><h3>Appendix I. Studies not-prioritised</h3><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng112er1appitab1"><a href="/books/NBK611982/table/niceng112er1.appi.tab1/?report=objectonly" target="object" title="Table" class="img_link icnblk_img" rid-ob="figobniceng112er1appitab1"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng112er1.appi.tab1"><a href="/books/NBK611982/table/niceng112er1.appi.tab1/?report=objectonly" target="object" rid-ob="figobniceng112er1appitab1">Table</a></h4></div></div></div><div id="niceng112er1.appj"><h3>Appendix J. Excluded studies</h3><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng112er1appjtab1"><a href="/books/NBK611982/table/niceng112er1.appj.tab1/?report=objectonly" target="object" title="Table" class="img_link icnblk_img" rid-ob="figobniceng112er1appjtab1"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng112er1.appj.tab1"><a href="/books/NBK611982/table/niceng112er1.appj.tab1/?report=objectonly" target="object" rid-ob="figobniceng112er1appjtab1">Table</a></h4></div></div></div></div></div><div class="fm-sec"><div><p>Final</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="https://www.gov.wales/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="https://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div><p><b>Update information</b>: <b>December 2024:</b> We amended the recommendations on referral and seeking specialist advice, and on oestrogen and choice of antibiotic or antiseptic prophylaxis. We did not review the evidence on these areas but made these changes based on committee expertise. See the <a href="https://www.nice.org.uk/guidance/ng112/chapter/Update-information" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">update information section in the 2024 version of this guideline</a> for more information.</p></div><p class="small">Created: October 2018; Last Update: December 2024.</p><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2024.</div><div class="small"><span class="label">Bookshelf ID: NBK611982</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/39937936" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">39937936</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="boxed-text" id="figobniceng112er1box1"><div id="niceng112er1.box1" class="box boxed-text-box whole_rhythm hide-overflow"><p>Four further systematic reviews were identified following stakeholder consultation and an updated search (May 2018). Luis et al. (2017) is a systematic review and Ledda et al. (2017) is an RCT both covering cranberry products, however, both studies were deprioritised as another systematic review also identified following stakeholder consultation on the same intervention was prioritised (<a class="bibr" href="#niceng112er1.appf.ref4" rid="niceng112er1.appf.ref4">Fu et al. [2017)</a>]; see <a href="#niceng112er1.appi">appendix I: studies not prioritised</a>). Fu et al. conducted a meta-analysis comparing cranberry products with placebo or no treatment in non-pregnant women. A third systematic review (<a class="bibr" href="#niceng112er1.appf.ref10" rid="niceng112er1.appf.ref10">Roshdibonab et al. [2017)</a>]) conducted the same comparison in children and was also included in the guideline. The remaining 15 references identified in the updated search were excluded. These are listed in <a href="#niceng112er1.appj">appendix J: excluded studies</a> with reasons for their exclusion.</p></div></article><article data-type="table-wrap" id="figobniceng112er1tab1"><div id="niceng112er1.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">Summary of included studies: non-pharmacological interventions</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK611982/table/niceng112er1.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng112er1.tab1_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng112er1.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_niceng112er1.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Number of participants</th><th id="hd_h_niceng112er1.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Population</th><th id="hd_h_niceng112er1.tab1_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Intervention</th><th id="hd_h_niceng112er1.tab1_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Comparison</th><th id="hd_h_niceng112er1.tab1_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Primary outcome</th></tr></thead><tbody><tr><td headers="hd_h_niceng112er1.tab1_1_1_1_1 hd_h_niceng112er1.tab1_1_1_1_2 hd_h_niceng112er1.tab1_1_1_1_3 hd_h_niceng112er1.tab1_1_1_1_4 hd_h_niceng112er1.tab1_1_1_1_5 hd_h_niceng112er1.tab1_1_1_1_6" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">Probiotics (lactobacillus)</td></tr><tr><td headers="hd_h_niceng112er1.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng112er1.appf.ref5" rid="niceng112er1.appf.ref5">Grin et al. 2013</a>
|
|
</p>
|
|
<p>Systematic review.</p>
|
|
<p>Multiple countries.</p>
|
|
<p>Follow-up up to 12 months</p>
|
|
</td><td headers="hd_h_niceng112er1.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>n=294</p>
|
|
<p>(5 RCTs)</p>
|
|
</td><td headers="hd_h_niceng112er1.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Premenopausal women with history of UTI, defined as one or more UTIs within the last 12 months</td><td headers="hd_h_niceng112er1.tab1_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lactobacillus (pessaries or oral; in 3 studies lactobacillus given after a course of antibiotics), for prophylaxis</td><td headers="hd_h_niceng112er1.tab1_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Placebo</td><td headers="hd_h_niceng112er1.tab1_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incidence of recurrent urinary tract infections</td></tr><tr><td headers="hd_h_niceng112er1.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng112er1.appf.ref12" rid="niceng112er1.appf.ref12">Schwenger et al. 2015</a>
|
|
</p>
|
|
<p>Systematic review.</p>
|
|
<p>Multiple countries.</p>
|
|
<p>Follow-up up to 28 days</p>
|
|
</td><td headers="hd_h_niceng112er1.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>n=735</p>
|
|
<p>(9 RCTs and quasi-RCTs)</p>
|
|
</td><td headers="hd_h_niceng112er1.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adults and children with history of at least 1 UTI or current UTI, 1 study in healthy women (some studies included children with VUR)</td><td headers="hd_h_niceng112er1.tab1_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Probiotics in any formulation for prophylaxis</td><td headers="hd_h_niceng112er1.tab1_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Placebo</p>
|
|
<p>Antibiotics</p>
|
|
</td><td headers="hd_h_niceng112er1.tab1_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Symptomatic bacterial urinary tract infection</td></tr><tr><td headers="hd_h_niceng112er1.tab1_1_1_1_1 hd_h_niceng112er1.tab1_1_1_1_2 hd_h_niceng112er1.tab1_1_1_1_3 hd_h_niceng112er1.tab1_1_1_1_4 hd_h_niceng112er1.tab1_1_1_1_5 hd_h_niceng112er1.tab1_1_1_1_6" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">D-Mannose</td></tr><tr><td headers="hd_h_niceng112er1.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng112er1.appf.ref7" rid="niceng112er1.appf.ref7">Kranjcec et al. 2014</a>
|
|
</p>
|
|
<p>RCT</p>
|
|
<p>Croatia</p>
|
|
<p>Follow-up 6 months</p>
|
|
</td><td headers="hd_h_niceng112er1.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">n=308</td><td headers="hd_h_niceng112er1.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-pregnant women with history of UTI, defined as at least 2 UTIs in the last 6 months and/or 3 UTIs in the last year</td><td headers="hd_h_niceng112er1.tab1_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Oral d-mannose for prophylaxis</td><td headers="hd_h_niceng112er1.tab1_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Antibiotic (nitrofurantoin)</p>
|
|
<p>No treatment</p>
|
|
</td><td headers="hd_h_niceng112er1.tab1_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Number of women experiencing a urinary tract infection</td></tr><tr><td headers="hd_h_niceng112er1.tab1_1_1_1_1 hd_h_niceng112er1.tab1_1_1_1_2 hd_h_niceng112er1.tab1_1_1_1_3 hd_h_niceng112er1.tab1_1_1_1_4 hd_h_niceng112er1.tab1_1_1_1_5 hd_h_niceng112er1.tab1_1_1_1_6" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">Cranberry products</td></tr><tr><td headers="hd_h_niceng112er1.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng112er1.appf.ref4" rid="niceng112er1.appf.ref4">Fu et al. 2017</a>
|
|
</p>
|
|
<p>Systematic review</p>
|
|
<p>Multiple countries</p>
|
|
<p>6 to 12 months follow up</p>
|
|
</td><td headers="hd_h_niceng112er1.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>n=1498</p>
|
|
<p>(7 RCTs)</p>
|
|
</td><td headers="hd_h_niceng112er1.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Generally healthy non-pregnant women with a history of UTI</td><td headers="hd_h_niceng112er1.tab1_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cranberry products (juice, tablets and powder capsules) for prophylaxis</td><td headers="hd_h_niceng112er1.tab1_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Placebo or no treatment</td><td headers="hd_h_niceng112er1.tab1_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Number of women experiencing a urinary tract infection</td></tr><tr><td headers="hd_h_niceng112er1.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. 2012</a>
|
|
</p>
|
|
<p>Systematic review.</p>
|
|
<p>Multiple countries.</p>
|
|
<p>Follow-up up to 12 months</p>
|
|
</td><td headers="hd_h_niceng112er1.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>n=4,473</p>
|
|
<p>(24 RCTs)</p>
|
|
</td><td headers="hd_h_niceng112er1.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adults susceptible to UTI including: people with a history of recurrent lower UTI (defined as more than 2 episodes in the last year); pregnant women; older people, people with cancer or spinal injury/neuropathic bladder and children with first or subsequent UTI</td><td headers="hd_h_niceng112er1.tab1_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cranberry products (juice, concentrate, capsules, or tablets) for prophylaxis</td><td headers="hd_h_niceng112er1.tab1_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Placebo, no treatment, water, methenamine hippurate, antibiotics or lactobacillus</td><td headers="hd_h_niceng112er1.tab1_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Number (incidence) of confirmed urinary tract infection</td></tr><tr><td headers="hd_h_niceng112er1.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng112er1.appf.ref10" rid="niceng112er1.appf.ref10">Roshdibonab et al. 2017</a>
|
|
</p>
|
|
<p>Multiple countries</p>
|
|
<p>3 to 17 months follow up</p>
|
|
</td><td headers="hd_h_niceng112er1.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>n=794</p>
|
|
<p>(10 RCTs)</p>
|
|
</td><td headers="hd_h_niceng112er1.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Children with history of UTI</td><td headers="hd_h_niceng112er1.tab1_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cranberry juice or capsules for prophylaxis</td><td headers="hd_h_niceng112er1.tab1_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Placebo or antibiotics</td><td headers="hd_h_niceng112er1.tab1_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Number of urinary tract infections</td></tr><tr><td headers="hd_h_niceng112er1.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng112er1.appf.ref2" rid="niceng112er1.appf.ref2">Beerepoot et al. 2011</a>
|
|
</p>
|
|
<p>RCT</p>
|
|
<p>Netherlands</p>
|
|
<p>Follow-up up to 15 months</p>
|
|
</td><td headers="hd_h_niceng112er1.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">n=221</td><td headers="hd_h_niceng112er1.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Premenopausal women with a history of recurrent UTI, defined as at least 3 self-reported UTIs in the last year</td><td headers="hd_h_niceng112er1.tab1_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cranberry capsules for prophylaxis</td><td headers="hd_h_niceng112er1.tab1_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Antibiotic (co-trimoxazole)</td><td headers="hd_h_niceng112er1.tab1_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Number of symptomatic urinary tract infections over 12 months</p>
|
|
<p>Proportion of patients with at least 1 symptomatic urinary tract infection during 12 months of prophylaxis use</p>
|
|
<p>Median time to the first symptomatic urinary tract infection</p>
|
|
</td></tr><tr><td headers="hd_h_niceng112er1.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng112er1.appf.ref13" rid="niceng112er1.appf.ref13">Uberos et al. 2012</a>
|
|
</p>
|
|
<p>RCT</p>
|
|
<p>Spain</p>
|
|
<p>Follow-up up to 12 months</p>
|
|
</td><td headers="hd_h_niceng112er1.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">n=192</td><td headers="hd_h_niceng112er1.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Children 1 month to 13 years, with a history of recurrent UTI (defined as at least 2 episodes in the last 6 months), VUR of any degree or renal pelvic dilation associated with UTI</td><td headers="hd_h_niceng112er1.tab1_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cranberry syrup for prophylaxis</td><td headers="hd_h_niceng112er1.tab1_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Antibiotic (trimethoprim)</td><td headers="hd_h_niceng112er1.tab1_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Number of urinary tract infection and safety</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Abbreviations: RCT, Randomised controlled trial; VUR, Vesicoureteral reflux</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng112er1tab2"><div id="niceng112er1.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">Summary of included studies: non-antimicrobial pharmacological interventions</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK611982/table/niceng112er1.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng112er1.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_niceng112er1.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_niceng112er1.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Number of participants</th><th id="hd_h_niceng112er1.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Population</th><th id="hd_h_niceng112er1.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Intervention</th><th id="hd_h_niceng112er1.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Comparison</th><th id="hd_h_niceng112er1.tab2_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Primary outcome</th></tr></thead><tbody><tr><td headers="hd_h_niceng112er1.tab2_1_1_1_1 hd_h_niceng112er1.tab2_1_1_1_2 hd_h_niceng112er1.tab2_1_1_1_3 hd_h_niceng112er1.tab2_1_1_1_4 hd_h_niceng112er1.tab2_1_1_1_5 hd_h_niceng112er1.tab2_1_1_1_6" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">Oestrogens</td></tr><tr><td headers="hd_h_niceng112er1.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng112er1.appf.ref9" rid="niceng112er1.appf.ref9">Perrotta et al. 2008</a>
|
|
</p>
|
|
<p>Systematic review.</p>
|
|
<p>Multiple countries</p>
|
|
<p>Follow-up up to 4 years</p>
|
|
</td><td headers="hd_h_niceng112er1.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>n=3,345</p>
|
|
<p>(9 RCTs)</p>
|
|
</td><td headers="hd_h_niceng112er1.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Post-menopausal women</td><td headers="hd_h_niceng112er1.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Oral oestrogens, with or without progestogens; or vaginal oestrogens, delivered by vaginal ring, vaginal pessaries, vaginal tablets</td><td headers="hd_h_niceng112er1.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Placebo or antibiotics</td><td headers="hd_h_niceng112er1.tab2_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Women with recurrent urinary tract infections</p>
|
|
<p>Urinary tract infections</p>
|
|
<p>Time until recurrence</p>
|
|
<p>Number of urinary infections/person/year</p>
|
|
</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng112er1tab3"><div id="niceng112er1.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">Summary of included studies: antimicrobials</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK611982/table/niceng112er1.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng112er1.tab3_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng112er1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_niceng112er1.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Number of participants</th><th id="hd_h_niceng112er1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Population</th><th id="hd_h_niceng112er1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Intervention</th><th id="hd_h_niceng112er1.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Comparison</th><th id="hd_h_niceng112er1.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Primary outcome</th></tr></thead><tbody><tr><td headers="hd_h_niceng112er1.tab3_1_1_1_1 hd_h_niceng112er1.tab3_1_1_1_2 hd_h_niceng112er1.tab3_1_1_1_3 hd_h_niceng112er1.tab3_1_1_1_4 hd_h_niceng112er1.tab3_1_1_1_5 hd_h_niceng112er1.tab3_1_1_1_6" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">Antibiotics versus placebo or no treatment</td></tr><tr><td headers="hd_h_niceng112er1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng112er1.appf.ref1" rid="niceng112er1.appf.ref1">Albert et al. 2004</a>
|
|
</p>
|
|
<p>Systematic review</p>
|
|
<p>Multiple countries.</p>
|
|
<p>Follow-up not clearly reported</p>
|
|
</td><td headers="hd_h_niceng112er1.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>n=1,120</p>
|
|
<p>(19 RCTs)</p>
|
|
</td><td headers="hd_h_niceng112er1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-pregnant women (both pre- and post-menopausal women) with at least 2 UTIs in the last year</td><td headers="hd_h_niceng112er1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Antibiotics of various classes administered for at least 6 months</td><td headers="hd_h_niceng112er1.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Placebo, antibiotics or another pharmacological non-antibiotic treatment</td><td headers="hd_h_niceng112er1.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Number of recurrences per patient-year using 1) microbiological criteria and 2) clinical criteria</p>
|
|
<p>Proportion of patients who had severe side effects</p>
|
|
<p>Proportion of patients who had mild side effects</p>
|
|
</td></tr><tr><td headers="hd_h_niceng112er1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng112er1.appf.ref3" rid="niceng112er1.appf.ref3">Dai et al. 2010</a>
|
|
</p>
|
|
<p>Systematic review</p>
|
|
<p>Multiple countries</p>
|
|
<p>Follow-up varied according to study</p>
|
|
</td><td headers="hd_h_niceng112er1.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>n=1,093</p>
|
|
<p>(7 RCTS)</p>
|
|
</td><td headers="hd_h_niceng112er1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Children with or without VUR</td><td headers="hd_h_niceng112er1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Antibiotics of various classes</td><td headers="hd_h_niceng112er1.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Placebo</td><td headers="hd_h_niceng112er1.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Deterioration of renal scars</td></tr><tr><td headers="hd_h_niceng112er1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng112er1.appf.ref8" rid="niceng112er1.appf.ref8">Muller et al. 2017</a>
|
|
</p>
|
|
<p>Systematic review</p>
|
|
<p>Multiple countries.</p>
|
|
<p>Follow-up varied according to study</p>
|
|
</td><td headers="hd_h_niceng112er1.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>n=3,052</p>
|
|
<p>(26 RCTs)</p>
|
|
</td><td headers="hd_h_niceng112er1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adults and children (authors conducted a mixed analysis of studies in adults, children or both); the ages of participants involved were not reported consistently, if at all.</td><td headers="hd_h_niceng112er1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Nitrofurantoin</td><td headers="hd_h_niceng112er1.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Placebo</td><td headers="hd_h_niceng112er1.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Occurrence of urinary tract infection</p>
|
|
<p>Mild adverse effects</p>
|
|
<p>Emergence of resistance</p>
|
|
</td></tr><tr><td headers="hd_h_niceng112er1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng112er1.appf.ref11" rid="niceng112er1.appf.ref11">Schneeberger al. 2015</a>
|
|
</p>
|
|
<p>Systematic review</p>
|
|
<p>US</p>
|
|
<p>Follow-up until delivery</p>
|
|
</td><td headers="hd_h_niceng112er1.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>n=200</p>
|
|
<p>(1 RCT)</p>
|
|
</td><td headers="hd_h_niceng112er1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pregnant women with history of 1 or more UTIs before or during pregnancy</td><td headers="hd_h_niceng112er1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Nitrofurantoin and close monitoring</td><td headers="hd_h_niceng112er1.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Close monitoring alone</td><td headers="hd_h_niceng112er1.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Recurrent urinary tract infection before birth (recurrent pyelonephritis, recurrent cystitis)</p>
|
|
<p>Preterm birth (less than 37 weeks)</p>
|
|
<p>Small for gestational age</p>
|
|
</td></tr><tr><td headers="hd_h_niceng112er1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng112er1.appf.ref14" rid="niceng112er1.appf.ref14">Williams and Craig 2011</a>
|
|
</p>
|
|
<p>Systematic review</p>
|
|
<p>Multiple countries.</p>
|
|
<p>Follow-up varied according to study</p>
|
|
</td><td headers="hd_h_niceng112er1.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>n=1,557</p>
|
|
<p>(12 RCTs)</p>
|
|
</td><td headers="hd_h_niceng112er1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Children (without VUR), however studies in which less than 50% of the population had VUR (any grade) were included.</td><td headers="hd_h_niceng112er1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Antibiotics of various classes</td><td headers="hd_h_niceng112er1.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Placebo</td><td headers="hd_h_niceng112er1.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Recurrence of urinary tract infections</p>
|
|
<p>Microbial resistance to prophylactic drug</p>
|
|
<p>Adverse events</p>
|
|
<p>Withdrawals due to adverse events</p>
|
|
</td></tr><tr><td headers="hd_h_niceng112er1.tab3_1_1_1_1 hd_h_niceng112er1.tab3_1_1_1_2 hd_h_niceng112er1.tab3_1_1_1_3 hd_h_niceng112er1.tab3_1_1_1_4 hd_h_niceng112er1.tab3_1_1_1_5 hd_h_niceng112er1.tab3_1_1_1_6" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">Antibiotics versus other antibiotics</td></tr><tr><td headers="hd_h_niceng112er1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng112er1.appf.ref8" rid="niceng112er1.appf.ref8">Muller et al. 2017</a>
|
|
</p>
|
|
<p>Systematic review</p>
|
|
<p>Multiple countries.</p>
|
|
<p>Follow-up varied according to study</p>
|
|
</td><td headers="hd_h_niceng112er1.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>n=3,052</p>
|
|
<p>(26 RCTs)</p>
|
|
</td><td headers="hd_h_niceng112er1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adults and children (authors conducted a mixed analysis of studies in adults, children or both); the ages of participants involved were not reported consistently, if at all.</td><td headers="hd_h_niceng112er1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Nitrofurantoin</td><td headers="hd_h_niceng112er1.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Different antibiotic classes:<ul><li class="half_rhythm"><div>Beta-lactams</div></li><li class="half_rhythm"><div>Quinolones</div></li><li class="half_rhythm"><div>Co-trimoxazole</div></li><li class="half_rhythm"><div>Trimethoprim</div></li><li class="half_rhythm"><div>Methenamine hippurate</div></li></ul></td><td headers="hd_h_niceng112er1.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Occurrence of urinary tract infection Mild adverse effects</td></tr><tr><td headers="hd_h_niceng112er1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng112er1.appf.ref1" rid="niceng112er1.appf.ref1">Albert et al. 2004</a>
|
|
</p>
|
|
<p>Systematic review</p>
|
|
<p>Multiple countries.</p>
|
|
<p>Follow-up not clearly reported</p>
|
|
</td><td headers="hd_h_niceng112er1.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>n=1,120</p>
|
|
<p>(19 RCTs)</p>
|
|
</td><td headers="hd_h_niceng112er1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-pregnant women (both pre- and post-menopausal women) with at least 2 UTIs in the last year</td><td headers="hd_h_niceng112er1.tab3_1_1_1_4 hd_h_niceng112er1.tab3_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Antibiotics of various classes</td><td headers="hd_h_niceng112er1.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Number of recurrences per patient-year using 1) microbiological criteria and 2) clinical criteria</p>
|
|
<p>Proportion of patients who had severe side effects</p>
|
|
<p>Proportion of patients who had mild side effects</p>
|
|
</td></tr><tr><td headers="hd_h_niceng112er1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng112er1.appf.ref14" rid="niceng112er1.appf.ref14">Williams and Craig 2011</a>
|
|
</p>
|
|
<p>Systematic review</p>
|
|
<p>Multiple countries.</p>
|
|
<p>Follow-up varied according to study</p>
|
|
</td><td headers="hd_h_niceng112er1.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>n=1,557</p>
|
|
<p>(12 RCTs)</p>
|
|
</td><td headers="hd_h_niceng112er1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Children (without VUR), however studies in which less than 50% of the population had VUR (any grade) were included.</td><td headers="hd_h_niceng112er1.tab3_1_1_1_4 hd_h_niceng112er1.tab3_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Antibiotics of various classes</td><td headers="hd_h_niceng112er1.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Recurrence of urinary tract infections</p>
|
|
<p>Microbial resistance to prophylactic drug</p>
|
|
<p>Adverse events</p>
|
|
<p>Withdrawals due to adverse events</p>
|
|
</td></tr><tr><td headers="hd_h_niceng112er1.tab3_1_1_1_1 hd_h_niceng112er1.tab3_1_1_1_2 hd_h_niceng112er1.tab3_1_1_1_3 hd_h_niceng112er1.tab3_1_1_1_4 hd_h_niceng112er1.tab3_1_1_1_5 hd_h_niceng112er1.tab3_1_1_1_6" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">Duration of antibiotic treatment (adults)</td></tr><tr><td headers="hd_h_niceng112er1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng112er1.appf.ref15" rid="niceng112er1.appf.ref15">Zhong et al. 2011</a>
|
|
</p>
|
|
<p>RCT</p>
|
|
<p>China</p>
|
|
<p>Follow-up12 months</p>
|
|
</td><td headers="hd_h_niceng112er1.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">n=68</td><td headers="hd_h_niceng112er1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Postmenopausal women</td><td headers="hd_h_niceng112er1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Antibiotic (continuous low-dose daily)</td><td headers="hd_h_niceng112er1.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Antibiotic (intermittent patient-initiated single-dose)</td><td headers="hd_h_niceng112er1.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Occurrence of urinary tract infection</p>
|
|
<p>Conditions predisposing to antibiotic use</p>
|
|
<p>Adverse events</p>
|
|
</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Abbreviations: RCT, Randomised controlled trial; VUR, vesicoureteral reflux</p></div></dd></dl></dl></div></div></div></article><article data-type="boxed-text" id="figobniceng112er1box2"><div id="niceng112er1.box2" class="box boxed-text-box whole_rhythm hide-overflow"><p>Two further systematic reviews were identified following stakeholder consultation and an updated search. <a class="bibr" href="#niceng112er1.appf.ref4" rid="niceng112er1.appf.ref4">Fu et al. (2017)</a> conducted a meta-analysis comparing cranberry products with placebo or no treatment in non-pregnant women and <a class="bibr" href="#niceng112er1.appf.ref10" rid="niceng112er1.appf.ref10">Roshdibonab et al. (2017)</a> conducted the same comparison in children.</p></div></article><article data-type="boxed-text" id="figobniceng112er1box3"><div id="niceng112er1.box3" class="box boxed-text-box whole_rhythm hide-overflow"><h3><span class="title">Evidence identified following stakeholder consultation</span></h3><p><a class="bibr" href="#niceng112er1.appf.ref4" rid="niceng112er1.appf.ref4">Fu et al. (2017)</a> compared cranberry in either juice or capsule form, for preventing UTIs in non-pregnant women, with a follow up of 6 to 12 months. Age of participants varied from 21 to 72 years old. The included studies differed in their definition of UTI, with most trials defining UTI through the presence of symptoms, and 4 requiring confirmed bacteriuria of varying thresholds. This data adds an additional 4 unique RCTs to the <a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. (2012)</a> analysis, including a total of 501 additional participants. Furthermore, 3 of the RCTs included in <a class="bibr" href="#niceng112er1.appf.ref4" rid="niceng112er1.appf.ref4">Fu et al. (2017)</a>, are also included in <a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. (2012)</a>, while 1 RCT included in <a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. (2012)</a> is not included in <a class="bibr" href="#niceng112er1.appf.ref4" rid="niceng112er1.appf.ref4">Fu et al. (2017)</a>.</p><p>Cranberry juice or capsules significantly reduced the incidence of UTI in non-pregnant women, diagnosed either by symptom presence or culture confirmation, compared with placebo or no treatment (7 RCTs, n=1498: 20.7% versus 26.5%; RR 0.74, 95% CI 0.55 to 0.98; very low quality evidence). When restricted to UTIs confirmed by culture, this difference was not significantly significant (5 RCTs, n=912: 19.8% versus 24.0%; RR 0.71, 95% CI 0.45 to 1.12; very low quality evidence).</p><p>Cranberry juice did not significantly reduce the incidence of UTI, diagnosed either by symptom presence or culture confirmation, compared with placebo or no treatment (6 RCTs, n= 1272: 22.0% versus 26.6%; RR 0.79, 95% CI 0.59 1.06, very low quality evidence). However, cranberry tablets did significantly reduce incidence of UTI compared with placebo (2 RCTs, n= 276: 13.5% versus 28.0%; RR 0.48, 95% CI 0.29 to 0.79; low quality evidence).</p></div></article><article data-type="boxed-text" id="figobniceng112er1box4"><div id="niceng112er1.box4" class="box boxed-text-box whole_rhythm hide-overflow"><h3><span class="title">Evidence identified following stakeholder consultation</span></h3><p><a class="bibr" href="#niceng112er1.appf.ref10" rid="niceng112er1.appf.ref10">Roshdibonab et al. (2017)</a> included 8 RCTs comparing cranberry taken daily in juice or capsule form, with placebo for recurrent UTI in children, with 2 to 12 month follow up. Children were aged between 1 to 13 years, with UTI diagnosed by positive urine culture in all studies. Two of the RCTs included in the meta-analysis included children with catheters. This data includes an additional 6 RCTs to the <a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. (2012)</a> analysis, including a total of 262 additional participants. The 2 RCTs included in <a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. (2012)</a> for this population are also included in <a class="bibr" href="#niceng112er1.appf.ref10" rid="niceng112er1.appf.ref10">Roshdibonab et al. (2017)</a>.</p><p>Children using cranberry juice or capsules showed a significant reduction in incidence of culture confirmed UTI compared with children taking placebo (8 RCTs, n= 571: OR 0.31, 95% CI 0.21 to 0.46; very low quality evidence).</p></div></article><article data-type="table-wrap" id="figobniceng112er1appitab1"><div id="niceng112er1.appi.tab1" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK611982/table/niceng112er1.appi.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng112er1.appi.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study reference</th><th id="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reason</th></tr></thead><tbody><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Afshar
|
|
K, Stothers
|
|
L, Scott
|
|
H, and MacNeily
|
|
A E (2012) Cranberry juice for the prevention of pediatric urinary tract infection: a randomized controlled trial. The Journal of urology
|
|
188(4 Suppl), 1584–7
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/22910239" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22910239</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This RCT does not provide additional evidence that adds to the evidence from a prioritised systematic review</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Antachopoulos
|
|
Charalampos, Ioannidou
|
|
Maria, Tratselas
|
|
Athanasios, Iosifidis
|
|
Elias, Katragkou
|
|
Aspasia, Kadiltzoglou
|
|
Paschalis, Kollios
|
|
Konstantinos, and Roilides
|
|
Emmanuel (2016) Comparison of cotrimoxazole vs. second-generation cephalosporins for prevention of urinary tract infections in children. Pediatric nephrology (Berlin, and Germany)
|
|
31(12), 2271–2276 [<a href="https://pubmed.ncbi.nlm.nih.gov/27525699" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27525699</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This RCT does not provide additional evidence that adds to the evidence from a prioritised systematic review</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bailey David
|
|
T, Dalton
|
|
Carol, Joseph Daugherty, F, and Tempesta Michael
|
|
S (2007) Can a concentrated cranberry extract prevent recurrent urinary tract infections in women? A pilot study. Phytomedicine: international journal of phytotherapy and phytopharmacology
|
|
14(4), 237–41
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/17296290" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17296290</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This RCT does not provide additional evidence that adds to the evidence from a prioritised systematic review</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Barbosa-Cesnik
|
|
Cibele, Brown Morton
|
|
B, Buxton
|
|
Miatta, Zhang
|
|
Lixin, DeBusscher
|
|
Joan, and Foxman
|
|
Betsy (2011) Cranberry juice fails to prevent recurrent urinary tract infection: results from a randomized placebo-controlled trial. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America
|
|
52(1), 23–30
|
|
[<a href="/pmc/articles/PMC3060891/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3060891</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/21148516" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21148516</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RCT included in a systematic review that has been prioritised</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Beerepoot
|
|
M A. J, Geerlings
|
|
S E, van Haarst, E P, van Charante, N Mensing, ter Riet, and G (2013) Nonantibiotic prophylaxis for recurrent urinary tract infections: a systematic review and meta-analysis of randomized controlled trials. The Journal of urology
|
|
190(6), 1981–9
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23867306" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23867306</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A higher quality systematic review has been prioritised (Perrotta et al. 2011)</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Beerepoot
|
|
Maj, Ter Riet
|
|
G, Nys
|
|
S, Wal
|
|
Wm, Borgie
|
|
Cajm, Reijke
|
|
Tm, Prins
|
|
Jm, Koeijers
|
|
J, Verbon
|
|
A, Stobberingh
|
|
Ee, and Geerlings
|
|
Se (2013) Lactobacilli versus antibiotics to prevent urinary tract infections: A randomized, double-blind, noninferiority trial in postmenopausal women. [Dutch]. Nederlands tijdschrift voor geneeskunde
|
|
157(10),
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This RCT does not provide additional evidence that adds to the evidence from a prioritised systematic review</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bianco
|
|
L, Perrelli
|
|
E, Towle
|
|
V, Ness
|
|
Ph, and Juthani-Mehta
|
|
M (2012) Pilot randomized controlled dosing study of cranberry capsules for reduction of bacteriuria plus pyuria in female nursing home residents. Journal of the American Geriatrics Society
|
|
60(6), 1180–1
|
|
[<a href="/pmc/articles/PMC3375874/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3375874</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22690994" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22690994</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This RCT does not provide additional evidence that adds to the evidence from a prioritised systematic review</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bosmans
|
|
JE, Beerepoot
|
|
MA, Prins
|
|
JM, ter Riet
|
|
G, and Geerlings
|
|
SE (2014) Cost-effectiveness of cranberries vs antibiotics to prevent urinary tract infections in premenopausal women: a randomized clinical trial. PloS one
|
|
9(4), e91939
|
|
[<a href="/pmc/articles/PMC3976255/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3976255</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24705418" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24705418</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No or fewer critical outcomes reported</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Caljouw Monique
|
|
A. A, van den Hout, Wilbert
|
|
B, Putter
|
|
Hein, Achterberg Wilco
|
|
P, Cools Herman
|
|
J. M, and Gussekloo
|
|
Jacobijn (2014) Effectiveness of cranberry capsules to prevent urinary tract infections in vulnerable older persons: a double-blind randomized placebo-controlled trial in long-term care facilities. Journal of the American Geriatrics Society
|
|
62(1), 103–10
|
|
[<a href="/pmc/articles/PMC4233974/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4233974</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25180378" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25180378</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This RCT does not provide additional evidence that adds to the evidence from a prioritised systematic review</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ferrara
|
|
Pietro, Romaniello
|
|
Luciana, Vitelli
|
|
Ottavio, Gatto
|
|
Antonio, Serva
|
|
Martina, and Cataldi
|
|
Luigi (2009) Cranberry juice for the prevention of recurrent urinary tract infections: a randomized controlled trial in children. Scandinavian journal of urology and nephrology
|
|
43(5), 369–72
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/19921981" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19921981</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RCT included in a systematic review that has been prioritised</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ledda
|
|
A, Bottari
|
|
A, Luzzi
|
|
R, Belcaro
|
|
G, Hu
|
|
S, Dugall
|
|
M, Hosoi
|
|
M, Ippolito
|
|
E, Corsi
|
|
M, Gizzi
|
|
G, Morazzoni
|
|
P, Riva
|
|
A, Giacomelli
|
|
L, and Togni
|
|
S (2015) Cranberry supplementation in the prevention of non-severe lower urinary tract infections: a pilot study. European review for medical and pharmacological sciences
|
|
19(1), 77–80
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25635978" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25635978</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A higher quality systematic review has been prioritised (<a class="bibr" href="#niceng112er1.appf.ref4" rid="niceng112er1.appf.ref4">Fu et al. 2017</a>)</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Luís, Â, Domingues F and Pereira L.
|
|
Can Cranberries Contribute to Reduce the Incidence of Urinary Tract Infections? A Systematic Review with Meta-Analysis and Trial Sequential Analysis of Clinical Trials. The Journal of Urology. Sept
|
|
2017;198(3):614–621
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|
[<a href="https://pubmed.ncbi.nlm.nih.gov/28288837" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28288837</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A higher quality systematic review has been prioritised (<a class="bibr" href="#niceng112er1.appf.ref4" rid="niceng112er1.appf.ref4">Fu et al. 2017</a>)</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Maki Kevin
|
|
C, Kaspar Kerrie
|
|
L, Khoo
|
|
Christina, Derrig Linda
|
|
H, Schild Arianne
|
|
L, and Gupta
|
|
Kalpana (2016) Consumption of a cranberry juice beverage lowered the number of clinical urinary tract infection episodes in women with a recent history of urinary tract infection. The American journal of clinical nutrition
|
|
103(6), 1434–42
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/27251185" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27251185</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This RCT does not provide additional evidence that adds to the evidence from a prioritised systematic review</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mathew
|
|
JL. Antibiotic prophylaxis following urinary tract infection in children: a systematic review of randomized controlled trials. Indian pediatrics. 2010
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|
Jul
|
|
1;47(7):599–605.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/20683113" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20683113</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A higher quality systematic review has been prioritised (<a class="bibr" href="#niceng112er1.appf.ref14" rid="niceng112er1.appf.ref14">Williams and Craig 2011</a>)</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
McMurdo Marion
|
|
E. T, Argo
|
|
Ishbel, Phillips
|
|
Gabby, Daly
|
|
Fergus, and Davey
|
|
Peter (2009) Cranberry or trimethoprim for the prevention of recurrent urinary tract infections? A randomized controlled trial in older women. The Journal of antimicrobial chemotherapy
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|
63(2), 389–95
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|
[<a href="/pmc/articles/PMC2639265/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2639265</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19042940" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19042940</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RCT included in a systematic review that has been prioritised</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mori
|
|
et al
|
|
2009, Antibiotic prophylaxis for children at risk of developing urinary tract infection: a systematic review. Acta paediatrica (Oslo, and Norway: 1992)
|
|
98(11), 1781–6 [<a href="https://pubmed.ncbi.nlm.nih.gov/19627258" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19627258</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A higher quality systematic review has been prioritised (<a class="bibr" href="#niceng112er1.appf.ref14" rid="niceng112er1.appf.ref14">Williams and Craig 2011</a>)</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Norinder Birgit Stattin, Norrby Ragnar, Palmgren Ann-Chatrin, Hollenberg Sofia, Eriksson
|
|
Ulla, and Nord Carl
|
|
Erik (2006) Microflora changes with norfloxacin and pivmecillinam in women with recurrent urinary tract infection. Antimicrobial agents and chemotherapy
|
|
50(4), 1528–30
|
|
[<a href="/pmc/articles/PMC1426930/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1426930</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/16569875" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16569875</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This RCT does not provide additional evidence that adds to the evidence from a prioritised systematic review</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Porru
|
|
D, Parmigiani
|
|
A, Tinelli
|
|
C, Barletta
|
|
D, Choussos
|
|
D, Di Franco
|
|
C, Bobbi
|
|
V, Bassi
|
|
S, Miller
|
|
O, Gardella
|
|
B, Nappi
|
|
R E, Spinillo
|
|
A, and Rovereto
|
|
B (2014) Oral D-mannose in recurrent urinary tract infections in women: A pilot study. Journal of Clinical Urology
|
|
7(3), 208–213
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This RCT does not provide additional evidence that adds to the evidence from a prioritised systematic review</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Price Jameca
|
|
Renee, Guran Larissa
|
|
A, Gregory
|
|
W Thomas, and McDonagh Marian
|
|
S (2016) Nitrofurantoin vs other prophylactic agents in reducing recurrent urinary tract infections in adult women: a systematic review and meta-analysis. American journal of obstetrics and gynecology
|
|
215(5), 548–560
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/27457111" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27457111</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A higher quality systematic review has been prioritised (<a class="bibr" href="#niceng112er1.appf.ref8" rid="niceng112er1.appf.ref8">Muller et al. 2017</a>)</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Salo
|
|
Jarmo, Uhari
|
|
Matti, Helminen
|
|
Merja, Korppi
|
|
Matti, Nieminen
|
|
Tea, Pokka
|
|
Tytti, and Kontiokari
|
|
Tero (2012) Cranberry juice for the prevention of recurrences of urinary tract infections in children: a randomized placebo-controlled trial. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America
|
|
54(3), 340–6
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/22100577" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22100577</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This RCT does not provide additional evidence that adds to the evidence from a prioritised systematic review</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sengupta
|
|
K, Alluri
|
|
K V, Golakoti
|
|
T, Gottumukkala
|
|
G V, Raavi
|
|
J, Kotchrlakota
|
|
L, Sigalan
|
|
S C, Dey
|
|
D, Ghosh
|
|
S, and Chatterjee
|
|
A (2011) A randomized, double blind, controlled, dose dependent clinical trial to evaluate the efficacy of a proanthocyanidin standardized whole cranberry (Vaccinium macrocarpon) powder on infections of the urinary tract. Current Bioactive Compounds
|
|
7(1), 39–46
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This RCT does not provide additional evidence that adds to the evidence from a prioritised systematic review</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Singh
|
|
Iqbal, Gautam Lokesh
|
|
Kumar, and Kaur Iqbal
|
|
R (2016) Effect of oral cranberry extract (standardized proanthocyanidin-A) in patients with recurrent UTI by pathogenic E. coli: a randomized placebo-controlled clinical research study. International urology and nephrology
|
|
48(9), 1379–86
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/27314247" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27314247</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This RCT does not provide additional evidence that adds to the evidence from a prioritised systematic review</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Stapleton Ann
|
|
E, Au-Yeung
|
|
Melissa, Hooton Thomas
|
|
M, Fredricks David
|
|
N, Roberts Pacita
|
|
L, Czaja Christopher
|
|
A, Yarova-Yarovaya
|
|
Yuliya, Fiedler
|
|
Tina, Cox
|
|
Marsha, and Stamm Walter
|
|
E (2011) Randomized, placebo-controlled phase 2 trial of a Lactobacillus crispatus probiotic given intravaginally for prevention of recurrent urinary tract infection. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America
|
|
52(10), 1212–7
|
|
[<a href="/pmc/articles/PMC3079401/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3079401</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/21498386" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21498386</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RCT included in a systematic review that has been prioritised</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Stapleton Ann
|
|
E, Dziura
|
|
James, Hooton Thomas
|
|
M, Cox Marsha
|
|
E, Yarova-Yarovaya
|
|
Yuliya, Chen
|
|
Shu, and Gupta
|
|
Kalpana (2012) Recurrent urinary tract infection and urinary Escherichia coli in women ingesting cranberry juice daily: a randomized controlled trial. Mayo Clinic proceedings
|
|
87(2), 143–50
|
|
[<a href="/pmc/articles/PMC3497550/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3497550</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22305026" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22305026</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This RCT does not provide additional evidence that adds to the evidence from a prioritised systematic review</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Takahashi
|
|
Satoshi, Hamasuna
|
|
Ryoichi, Yasuda
|
|
Mitsuru, Arakawa
|
|
Soichi, Tanaka
|
|
Kazushi, Ishikawa
|
|
Kiyohito, Kiyota
|
|
Hiroshi, Hayami
|
|
Hiroshi, Yamamoto
|
|
Shingo, Kubo
|
|
Tatsuhiko, and Matsumoto
|
|
Tetsuro (2013) A randomized clinical trial to evaluate the preventive effect of cranberry juice (UR65) for patients with recurrent urinary tract infection. Journal of infection and chemotherapy: official journal of the Japan Society of Chemotherapy
|
|
19(1), 112–7
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/22961092" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22961092</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This RCT does not provide additional evidence that adds to the evidence from a prioritised systematic review</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
van den Hout
|
|
WB, Caljouw
|
|
MA, Putter
|
|
H, Cools
|
|
HJ, and Gussekloo
|
|
J (2014) Cost-effectiveness of cranberry capsules to prevent urinary tract infection in long-term care facilities: economic evaluation with a randomized controlled trial. Journal of the American Geriatrics Society
|
|
62(1), 111–6
|
|
[<a href="/pmc/articles/PMC4233962/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4233962</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25180379" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25180379</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No or fewer critical outcomes reported</td></tr><tr><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wang
|
|
Chih-Hung, Fang
|
|
Cheng-Chung, Chen
|
|
Nai-Chuan, Liu Sot
|
|
Shih-Hung, Yu
|
|
Ping-Hsun, Wu
|
|
Tao-Yu, Chen
|
|
Wei-Ting, Lee
|
|
Chien-Chang, and Chen
|
|
Shyr-Chyr (2012) Cranberry-containing products for prevention of urinary tract infections in susceptible populations: a systematic review and meta-analysis of randomized controlled trials. Archives of internal medicine
|
|
172(13), 988–96
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/22777630" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22777630</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A higher quality systematic review has been prioritised (<a class="bibr" href="#niceng112er1.appf.ref6" rid="niceng112er1.appf.ref6">Jepson et al. 2012</a>)</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng112er1appjtab1"><div id="niceng112er1.appj.tab1" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK611982/table/niceng112er1.appj.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng112er1.appj.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study reference</th><th id="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reason for exclusion</th></tr></thead><tbody><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Altarac
|
|
Silvio, and Papes
|
|
Dino (2014) Use of D-mannose in prophylaxis of recurrent urinary tract infections (UTIs) in women. BJU international
|
|
113(1), 9–10
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/24215164" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24215164</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (literature review)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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Aydin
|
|
A, Ahmed
|
|
K, Zaman
|
|
I, Khan
|
|
M S, and Dasgupta
|
|
P (2015) Recurrent urinary tract infections in women. Obstetrical and Gynecological Survey
|
|
70(10), 621–622q2 [<a href="https://pubmed.ncbi.nlm.nih.gov/25410372" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25410372</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (literature review)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Beerepoot
|
|
Maj, Ter Riet
|
|
G, Nys
|
|
S, Wal
|
|
Wm, Borgie
|
|
Cajm, Reijke
|
|
Tm, Prins
|
|
Jm, Koeijers
|
|
J, Verbon
|
|
A, Stobberingh
|
|
E E, and Geerlings S E (2012) Predictive value of Escherichia coli susceptibility in strains causing asymptomatic bacteriuria for women with recurrent symptomatic urinary tract infections receiving prophylaxis. Clinical Microbiology and Infection. 1;18(4). [<a href="https://pubmed.ncbi.nlm.nih.gov/22329638" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22329638</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Beversdorf
|
|
D Q, Galloway
|
|
H S, Foster
|
|
Sr, R T, and Tatum
|
|
P E (2011) Preventing recurrent urinary tract infections in a woman with dementia. Clinical Geriatrics
|
|
19(11), 33–35
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Unable to source study</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bleidorn
|
|
Jutta, Hummers-Pradier
|
|
Eva, Schmiemann
|
|
Guido, Wiese
|
|
Birgitt, and Gagyor
|
|
Ildiko (2016) Recurrent urinary tract infections and complications after symptomatic versus antibiotic treatment: follow-up of a randomised controlled trial. German medical science: GMS e-journal
|
|
14, Doc01
|
|
[<a href="/pmc/articles/PMC4749724/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4749724</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26909012" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26909012</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (retrospective long-term follow-up analysis)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bonetta
|
|
A, Derelli
|
|
R, and Pierro
|
|
F (2011) Cranberry extracts reduce urinary tract infections during radiotherapy for prostate adenocarcinoma. Anticancer research
|
|
31(5), 1849–1850
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Unable to source study</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Braga Luis
|
|
H, Pemberton
|
|
Julia, Heaman
|
|
Jessie, DeMaria
|
|
Jorge, and Lorenzo Armando
|
|
J (2014) Pilot randomized, placebo controlled trial to investigate the effect of antibiotic prophylaxis on the rate of urinary tract infection in infants with prenatal hydronephrosis. The Journal of urology
|
|
191(5 Suppl), 1501–7
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/24679865" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24679865</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not a relevant study</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Brandstrom
|
|
P (2011) The swedish reflux trial. Pediatric nephrology (Berlin, and Germany)
|
|
26(9), 1733
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Brandström
|
|
P, Jodal
|
|
U, Sillén
|
|
U, and Hansson
|
|
S (2011) The Swedish reflux trial: review of a randomized, controlled trial in children with dilating vesicoureteral reflux. Journal of pediatric urology
|
|
7(6), 594–600
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/21807562" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21807562</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Brandstrom
|
|
P, and Hansson
|
|
S (2013) Growth in children with dilating VUR-a follow up of the swedish reflux trial. Pediatric nephrology (Berlin, and Germany)
|
|
28(8), 1391
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Canning
|
|
D A (2010) Antibiotic prophylaxis and recurrent urinary tract infection in children. Journal of Urology
|
|
184(5), 2135
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Unable to source study</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Cayley
|
|
Jr, and W E (2013) Are cranberry products effective for the prevention of urinary tract infections?. American Family Physician
|
|
88(11), 745–746
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/24364520" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24364520</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (commentary)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Cote
|
|
J, Caillet
|
|
S, Doyon
|
|
G, Sylvain
|
|
JF, and Lacroix
|
|
M (2010) Bioactive compounds in cranberries and their biological properties. Critical reviews in food science and nutrition
|
|
50(7), 666–79
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/20694928" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20694928</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not a relevant study</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Damiano
|
|
Rocco, Quarto
|
|
Giuseppe, Bava
|
|
Ilaria, Ucciero
|
|
Giuseppe, De
|
|
Domenico, Renato, Palumbo Michele
|
|
I, and Autorino
|
|
Riccardo (2011) Prevention of recurrent urinary tract infections by intravesical administration of hyaluronic acid and chondroitin sulphate: a placebo-controlled randomised trial. European urology
|
|
59(4), 645–51
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/21272992" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21272992</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Poor relevance against search terms (intervention)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Damiano
|
|
R, Quarto
|
|
G, Bava
|
|
I, Ucciero
|
|
G, De Domenico, R, Palumbo
|
|
M I, and Autorino
|
|
R (2011) Erratum: Prevention of recurrent urinary tract infections by intravesical administration of hyaluronic acid and chondroitin sulphate: A placebo-controlled randomised trial (European Urology (2011) 59 (645–651)). European Urology
|
|
60(1), 193
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/21272992" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21272992</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Poor relevance against search terms (intervention)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Dessi
|
|
A, Atzei
|
|
A, and Fanos
|
|
V (2011) Cranberry in children: Prevention of recurrent urinary tract infections and review of the literature. Brazilian Journal of Pharmacognosy
|
|
21(5), 807–813
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (literature review)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
De Vita, Davide, and Giordano
|
|
Salvatore (2012) Effectiveness of intravesical hyaluronic acid/chondroitin sulfate in recurrent bacterial cystitis: a randomized study. International urogynecology journal
|
|
23(12), 1707–13
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/22614285" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22614285</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Poor relevance against search terms (intervention)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
De
|
|
Vita, Davide, Antell Henrik, and Giordano
|
|
Salvatore (2013) Effectiveness of intravesical hyaluronic acid with or without chondroitin sulfate for recurrent bacterial cystitis in adult women: a meta-analysis. International urogynecology journal
|
|
24(4), 545–52
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23129247" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23129247</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Poor relevance against search terms (intervention)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Dieter
|
|
A A (2015) Cranberry capsules (2 taken twice daily for an average 38 days) reduce the risk of postoperative urinary tract infection in women undergoing benign gynaecological surgery involving intraoperative catheterisation. Evidence-Based Medicine
|
|
20(4), 137
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/26126759" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26126759</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (commentary)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Donabedian
|
|
H (2006) Nutritional therapy and infectious diseases: a two-edged sword. Nutrition journal
|
|
5, 21
|
|
[<a href="/pmc/articles/PMC1570358/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1570358</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/16952310" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16952310</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not a relevant study</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Dotis
|
|
J, Printza
|
|
N, Stabouli
|
|
S, Pavlaki
|
|
A, Samara
|
|
S, and Papachristou
|
|
F (2014) Efficasy of cranberry capsules to prevent recurences of urinary tract infections. Pediatric nephrology (Berlin, and Germany)
|
|
29(9), 1793–4
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Unable to source study</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Duenas-Garcia
|
|
O F, Sullivan
|
|
G, Hall
|
|
C D, Flynn
|
|
M K, and O'Dell
|
|
K (2016) Pharmacological agents to decrease new episodes of recurrent lower urinary tract infections in postmenopausal women. A systematic review. Female Pelvic Medicine and Reconstructive Surgery
|
|
22(2), 63–69
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/26825411" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26825411</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not a relevant study</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Durham Spencer
|
|
H, Stamm Pamela
|
|
L, and Eiland Lea
|
|
S (2015) Cranberry Products for the Prophylaxis of Urinary Tract Infections in Pediatric Patients. The Annals of pharmacotherapy
|
|
49(12), 1349–56
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/26400007" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26400007</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (literature review)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Edmonson
|
|
M Bruce, and Eickhoff Jens
|
|
C (2017) Weight Gain and Obesity in Infants and Young Children Exposed to Prolonged Antibiotic Prophylaxis. JAMA pediatrics
|
|
171(2), 150–156
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/28027334" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28027334</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Eells Samantha
|
|
J, McKinnell James
|
|
A, and Miller Loren
|
|
G (2011) Daily cranberry prophylaxis to prevent recurrent urinary tract infections may be beneficial in some populations of women. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America
|
|
52(11), 1393–5 [<a href="/pmc/articles/PMC3916750/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3916750</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/21596685" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21596685</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (commentary)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Epp
|
|
Annette, Larochelle
|
|
Annick, Lovatsis
|
|
Danny, Walter Jens-Erik, Easton William, Farrell Scott A, Girouard Lise, Gupta
|
|
Chander, Harvey Marie-Andree, Robert Magali, Ross
|
|
Sue, Schachter
|
|
Joyce, Schulz Jane A, Wilkie David, Ehman
|
|
William, Domb
|
|
Sharon, Gagnon
|
|
Andree, Hughes
|
|
Owen, Konkin
|
|
Jill, Lynch
|
|
Joanna, Marshall
|
|
Cindy, Society of, Obstetricians, Gynaecologists of, and Canada (2010) Recurrent urinary tract infection. Journal of obstetrics and gynaecology Canada: JOGC = Journal d'obstetrique et gynecologie du Canada: JOGC
|
|
32(11), 1082–101 [<a href="https://pubmed.ncbi.nlm.nih.gov/21176321" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21176321</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (literature review)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Espino
|
|
M, Areses
|
|
R, Meseguer
|
|
Cg, Pena
|
|
A, Melgosa
|
|
M, Ruperez
|
|
M, Mitjavilla
|
|
M, and Albillos
|
|
Jc (2012) Antibiotic prophylaxis inhighdegree vesicoureteral reflux. Prospective, randomized and multicentric study. Preliminary results. Pediatric nephrology (Berlin, and Germany)
|
|
27(9), 1648–9
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (commentary)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Falakaflaki
|
|
B, Fallah
|
|
R, Jamshidi
|
|
Mr, Moezi
|
|
F, and Torabi
|
|
Z (2007) Comparison of nitrofurantoin and trimethoprim-sulphamethoxazole for long-term prophylaxis in children with recurrent urinary tract infections. International Journal of Pharmacology
|
|
3(2), 179–82
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Fanos
|
|
V, Atzei
|
|
A, Zaffanello
|
|
M, Piras
|
|
A, and Cataldi
|
|
L (2006) Cranberry and prevention of urinary tract infections in children. Journal of chemotherapy (Florence, and Italy)
|
|
18 Spec no 3, 21–4 [<a href="https://pubmed.ncbi.nlm.nih.gov/16789368" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16789368</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (literature review)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Fernández-Puentes
|
|
V, Uberos
|
|
J, Rodríguez-Belmonte
|
|
R, Nogueras-Ocaña
|
|
M, Blanca-Jover
|
|
E, and Narbona-López
|
|
E (2015) Efficacy and safety profile of cranberry in infants and children with recurrent urinary tract infection. Anales de pediatria (barcelona, and spain: 2003)
|
|
82(6), 397–403 [<a href="https://pubmed.ncbi.nlm.nih.gov/25300782" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25300782</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Unable to source</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Flower
|
|
Andrew, Wang Li-Qiong, Lewith George, Liu Jian
|
|
Ping, and Li
|
|
Qing (2015) Chinese herbal medicine for treating recurrent urinary tract infections in women. The Cochrane database of systematic reviews (6), CD010446
|
|
[<a href="/pmc/articles/PMC6481503/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6481503</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26040964" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26040964</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Does not reflect usual UK practice</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Fonseca Fernando
|
|
F, Tanno Fabio
|
|
Y, and Nguyen Hiep
|
|
T (2012) Current options in the management of primary vesicoureteral reflux in children. Pediatric clinics of North America
|
|
59(4), 819–34
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/22857830" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22857830</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Foxman
|
|
B, Cronenwett
|
|
AE, Spino
|
|
C, Berger
|
|
MB, and Morgan
|
|
DM (2015) Cranberry juice capsules and urinary tract infection after surgery: results of a randomized trial. American journal of obstetrics and gynecology
|
|
213(2), 194.e1-8 [<a href="/pmc/articles/PMC4519382/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4519382</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25882919" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25882919</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Foxman
|
|
Betsy, Cronenwett Anna
|
|
E. W, Spino
|
|
Cathie, Berger Mitchell
|
|
B, and Morgan Daniel
|
|
M (2015) Cranberry juice capsules and urinary tract infection after surgery: results of a randomized trial. American journal of obstetrics and gynecology
|
|
213(2), 194.e1-8 [<a href="/pmc/articles/PMC4519382/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4519382</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25882919" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25882919</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Duplicate</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Fromentin
|
|
E, Vostalova
|
|
J, Vidlar
|
|
A, Galandakova
|
|
A, Vrbkova
|
|
J, Ulrichova
|
|
J, Student
|
|
V, and Simanek
|
|
V (2014) A randomized, double-blind, placebo-controlled clinical trial to investigate the efficacy of cranberry fruit powder (Pacran) in the prevention of recurrent urinary tract infection in women. FASEB journal
|
|
28(1 suppl. 1),
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abstract only</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gallien
|
|
P, and Reymann
|
|
Jm (2008) Cranberry for prevention of urinary tract infections in multiple sclerosis patients. ClinicalTrials gov (www clinicaltrials gov) (accessed 4 November 2010),
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (study registration)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gallien
|
|
Philippe, Amarenco
|
|
Gerard, Benoit
|
|
Nicolas, Bonniaud
|
|
Veronique, Donze
|
|
Cecile, Kerdraon
|
|
Jacques, de Seze, Marianne, Denys
|
|
Pierre, Renault
|
|
Alain, Naudet
|
|
Florian, and Reymann Jean
|
|
Michel (2014) Cranberry versus placebo in the prevention of urinary infections in multiple sclerosis: a multicenter, randomized, placebo-controlled, double-blind trial. Multiple sclerosis (Houndmills, Basingstoke, and England)
|
|
20(9), 1252–9 [<a href="https://pubmed.ncbi.nlm.nih.gov/24402038" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24402038</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Garin Eduardo
|
|
H, Olavarria
|
|
Fernando, Garcia
|
|
Nieto, Victor, Valenciano
|
|
Blanca, Campos
|
|
Alfonso, and Young
|
|
Linda (2006) Clinical significance of primary vesicoureteral reflux and urinary antibiotic prophylaxis after acute pyelonephritis: a multicenter, randomized, controlled study. Pediatrics
|
|
117(3), 626–32
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/16510640" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16510640</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gautam
|
|
L, Singh
|
|
I, Gautam
|
|
Lk, Kaur
|
|
Ir, Rai
|
|
S, and Joshi
|
|
Mk (2014) Effect of oral cranberry extract (standardised proanthocyanidin-a) on the uropathogenic bacteria in urine of patients with subclinical/recurrent uti: A randomised placebo controlled clinical study. Indian journal of urology
|
|
30, S152
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abstract only</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gupta
|
|
A (2007) Cranberry and Prevention of UTI - A Comprehensive Approach. <a href="http://www.clinicaltrials.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.clinicaltrials.gov</a>,
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (study registration)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gucuk
|
|
Adnan, Burgu
|
|
Berk, Gokce
|
|
Ilker, Mermerkaya
|
|
Murat, and Soygur
|
|
Tarkan (2013) Do antibiotic prophylaxis and/or circumcision change periurethral uropathogen colonization and urinary tract infection rates in boys with VUR?. Journal of pediatric urology
|
|
9(6 Pt B), 1131–6
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23721792" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23721792</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not a relevant study</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gupta
|
|
K, and Trautner
|
|
B W (2013) Diagnosis and management of recurrent urinary tract infections in non-pregnant women. BMJ (Online)
|
|
346(7910), f3140 [<a href="/pmc/articles/PMC4688544/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4688544</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23719637" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23719637</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (literature review)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Handeland
|
|
Maria, Grude
|
|
Nils, Torp
|
|
Torfinn, and Slimestad
|
|
Rune (2014) Black chokeberry juice (Aronia melanocarpa) reduces incidences of urinary tract infection among nursing home residents in the long term--a pilot study. Nutrition research (New York, and N.Y.)
|
|
34(6), 518–25 [<a href="https://pubmed.ncbi.nlm.nih.gov/25026919" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25026919</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not a relevant study</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hari
|
|
P, Sarin
|
|
Y K, and Mathew
|
|
J L (2014) Antimicrobial prophylaxis for children with vesicoureteral reflux. Indian Pediatrics
|
|
51(7), 571–574
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hari
|
|
Pankaj, Hari
|
|
Smriti, Sinha
|
|
Aditi, Kumar
|
|
Rakesh, Kapil
|
|
Arti, Pandey Ravindra
|
|
Mohan, and Bagga
|
|
Arvind (2015) Antibiotic prophylaxis in the management of vesicoureteric reflux: a randomized double-blind placebo-controlled trial. Pediatric nephrology (Berlin, and Germany)
|
|
30(3), 479–86 [<a href="https://pubmed.ncbi.nlm.nih.gov/25173357" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25173357</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Higgs
|
|
R (2010) Pediatrics: Modest effect of prophylactic antibiotics on UTI in children. Nature Reviews Urology
|
|
7(1), 5
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (commentary)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hodson
|
|
E M, Wheeler
|
|
D M, Vimalchandra
|
|
D, Smith
|
|
G H, and Craig
|
|
J C (2007) Interventions for primary vesicoureteric reflux. The Cochrane database of systematic reviews (3), CD001532
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/17636679" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17636679</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Jepson
|
|
RG, Mihaljevic
|
|
L, and Craig
|
|
J (2000) Cranberries for preventing urinary tract infections. The Cochrane database of systematic reviews (2), CD001321
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/10796774" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10796774</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Updated systematic review available</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Jepson
|
|
RG, Mihaljevic
|
|
L, and Craig
|
|
J (2001) Cranberries for preventing urinary tract infections. The Cochrane database of systematic reviews (3), CD001321
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/11686987" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11686987</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Updated systematic review available</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Jepson
|
|
RG, Mihaljevic
|
|
L, and Craig
|
|
J (2004) Cranberries for preventing urinary tract infections. The Cochrane database of systematic reviews (2), CD001321 [<a href="https://pubmed.ncbi.nlm.nih.gov/14973968" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14973968</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Updated systematic review available</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Jepson Ruth
|
|
G, and Craig Jonathan
|
|
C (2007) A systematic review of the evidence for cranberries and blueberries in UTI prevention. Molecular nutrition & food research
|
|
51(6), 738–45
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/17492798" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17492798</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Updated systematic review available</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Jepson
|
|
R G, and Craig
|
|
J C (2008) Cranberries for preventing urinary tract infections. The Cochrane database of systematic reviews (1), CD001321
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/18253990" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18253990</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Updated systematic review available</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Jodal
|
|
Ulf, Smellie Jean M, Lax Hildegard, and Hoyer Peter
|
|
F (2006) Ten-year results of randomized treatment of children with severe vesicoureteral reflux. Final report of the International Reflux Study in Children. Pediatric nephrology (Berlin, and Germany)
|
|
21(6), 785–92 [<a href="https://pubmed.ncbi.nlm.nih.gov/16565873" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16565873</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Juthani-Mehta
|
|
Manisha, Van
|
|
Ness, Peter H, Bianco Luann, Rink
|
|
Andrea, Rubeck
|
|
Sabina, Ginter
|
|
Sandra, Argraves
|
|
Stephanie, Charpentier
|
|
Peter, Acampora
|
|
Denise, Trentalange
|
|
Mark, Quagliarello
|
|
Vincent, and Peduzzi
|
|
Peter (2016) Effect of Cranberry Capsules on Bacteriuria Plus Pyuria Among Older Women in Nursing Homes: A Randomized Clinical Trial. JAMA
|
|
316(18), 1879–1887
|
|
[<a href="/pmc/articles/PMC5300771/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5300771</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27787564" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27787564</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
LaPlante
|
|
K L, Gill
|
|
C M, and Rowley
|
|
D (2017) Cranberry capsules for bacteriuria plus pyuria in nursing home residents. JAMA Journal of the American Medical Association
|
|
317(10), 1078 [<a href="https://pubmed.ncbi.nlm.nih.gov/28291884" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28291884</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (commentary)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Larcombe
|
|
James (2015) Urinary tract infection in children: recurrent infections. BMJ clinical evidence
|
|
2015, [<a href="/pmc/articles/PMC4463760/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4463760</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26067232" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26067232</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (Review of systematic reviews/RCTs)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lee
|
|
B B, Simpson
|
|
J M, Craig
|
|
J C, and Bhuta
|
|
T (2007) Methenamine hippurate for preventing urinary tract infections. The Cochrane database of systematic reviews (4), CD003265
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/11869659" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11869659</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lee Linda
|
|
C, Lorenzo Armando
|
|
J, and Koyle Martin
|
|
A (2016) The role of voiding cystourethrography in the investigation of children with urinary tract infections. Canadian Urological Association journal = Journal de l'Association des urologues du Canada
|
|
10(5–6), 210–214 [<a href="/pmc/articles/PMC5045350/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5045350</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27713802" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27713802</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not a relevant study</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lee Seung Joo, Shim Yoon Hee, Cho Su
|
|
Jin, and Lee Jung
|
|
Won (2007) Probiotics prophylaxis in children with persistent primary vesicoureteral reflux. Pediatric nephrology (Berlin, and Germany)
|
|
22(9), 1315–20 [<a href="https://pubmed.ncbi.nlm.nih.gov/17530295" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17530295</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lee Seung
|
|
Joo, and Lee Jung
|
|
Won (2015) Probiotics prophylaxis in infants with primary vesicoureteral reflux. Pediatric nephrology (Berlin, and Germany)
|
|
30(4), 609–13 [<a href="https://pubmed.ncbi.nlm.nih.gov/25354903" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25354903</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ledda
|
|
A, Bottari
|
|
A, Luzzi
|
|
R, Belcaro
|
|
G, Hu
|
|
S, Dugall
|
|
M, Hosoi
|
|
M, Ippolito
|
|
E, Corsi
|
|
M, Gizzi
|
|
G, Morazzoni
|
|
P, Riva
|
|
A, Giacomelli
|
|
L, and Togni
|
|
S (2015) Cranberry supplementation in the prevention of non-severe lower urinary tract infections: a pilot study. European review for medical and pharmacological sciences
|
|
19(1), 77–80
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25635978" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25635978</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (observational study)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Leo
|
|
V, Cappelli
|
|
V, Massaro
|
|
Mg, Tosti
|
|
C, and Morgante
|
|
G (2017) Evaluation of the effects of a natural dietary supplement with cranberry, Noxamicina® and D-mannose in recurrent urinary infections in perimenopausal women. Minerva ginecologica
|
|
69(4), 336–341
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/28608666" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28608666</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-English language</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lo
|
|
V, Wah
|
|
Y, and Maggio
|
|
L (2011) Antibiotic prophylaxis to prevent recurrent UTI in children. American Family Physician
|
|
84(2), 3–4
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/21887883" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21887883</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (commentary)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Long
|
|
Elliot, Colquhoun
|
|
Samantha, and Carapetis Jonathan
|
|
R (2006) Antibiotic prophylaxis for the prevention of recurrent urinary tract infections in children. Advances in experimental medicine and biology
|
|
582, 243–9
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/16802633" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16802633</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (book article)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lorenzo
|
|
A J, and Braga
|
|
L H. P (2013) Use of cranberry products does not appear to be associated with a significant reduction in incidence of recurrent urinary tract infections. Evidence-Based Medicine
|
|
18(5), 181–182
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23416416" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23416416</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (commentary)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mattoo Tej
|
|
K (2007) Medical management of vesicoureteral reflux--quiz within the article. Don't overlook placebos. Pediatric nephrology (Berlin, and Germany)
|
|
22(8), 1113–20 [<a href="/pmc/articles/PMC6904391/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6904391</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/17483966" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17483966</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not a relevant study</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mattoo Tej
|
|
K, Chesney Russell
|
|
W, Greenfield Saul
|
|
P, Hoberman
|
|
Alejandro, Keren
|
|
Ron, Mathews
|
|
Ranjiv, Gravens-Mueller
|
|
Lisa, Ivanova
|
|
Anastasia, Carpenter Myra
|
|
A, Moxey-Mims
|
|
Marva, Majd
|
|
Massoud, Ziessman Harvey
|
|
A, and Investigators Rivur Trial (2016) Renal Scarring in the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) Trial. Clinical journal of the American Society of Nephrology: CJASN
|
|
11(1), 54–61
|
|
[<a href="/pmc/articles/PMC4702233/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4702233</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26555605" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26555605</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mazokopakis Elias
|
|
E, Karefilakis Christos
|
|
M, and Starakis Ioannis
|
|
K (2009) Efficacy of cranberry capsules in prevention of urinary tract infections in postmenopausal women. Journal of alternative and complementary medicine (New York, and N.Y.)
|
|
15(11), 1155 [<a href="https://pubmed.ncbi.nlm.nih.gov/19922246" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19922246</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (commentary)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mohseni
|
|
Mohammad-Javad, Aryan
|
|
Zahra, Emamzadeh-Fard
|
|
Sahra, Paydary
|
|
Koosha, Mofid
|
|
Vahid, Joudaki
|
|
Hasan, and Kajbafzadeh
|
|
Abdol-Mohammad (2013) Combination of probiotics and antibiotics in the prevention of recurrent urinary tract infection in children. Iranian journal of pediatrics
|
|
23(4), 430–8
|
|
[<a href="/pmc/articles/PMC3883373/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3883373</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24427497" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24427497</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mutlu
|
|
Hatice, and Ekinci
|
|
Zelal (2012) Urinary tract infection prophylaxis in children with neurogenic bladder with cranberry capsules: randomized controlled trial. ISRN pediatrics
|
|
2012, 317280
|
|
[<a href="/pmc/articles/PMC3395198/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3395198</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22811926" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22811926</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Naber Kurt
|
|
G, Cho
|
|
Yong-Hyun, Matsumoto
|
|
Tetsuro, and Schaeffer Anthony
|
|
J (2009) Immunoactive prophylaxis of recurrent urinary tract infections: a meta-analysis. International journal of antimicrobial agents
|
|
33(2), 111–9
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/18963856" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18963856</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Does not reflect usual UK practice</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nachum
|
|
Z, Braverman
|
|
M, Letova
|
|
Ygz, Salim
|
|
R, and Chazan
|
|
B (2015) The effect of preventive antibiotic treatment in the postpartum period on urinary tract infection (UTI) rate in women treated during pregnancy for recurrent UTI e a prospective randomized controlled study. American journal of obstetrics and gynecology
|
|
212(1 suppl. 1), S399–s400
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abstract only</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nagler Evi Vt, Williams Gabrielle, Hodson Elisabeth
|
|
M, and Craig Jonathan
|
|
C (2011) Interventions for primary vesicoureteric reflux. The Cochrane database of systematic reviews (6), CD001532
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/21678334" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21678334</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not a relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2008) Prospective, randomized, double-blind, placebo-controlled study on parallel groups evaluating the efficacy and safety of cranberry (Vaccinium Macrocarpon) in prevention of urinary tract infections in multiple sclerosis patients. <a href="https://clinicaltrials.gov/ct2/show/NCT00280592" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinicaltrials.gov/ct2/show/NCT00280592</a>,
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (trial registration)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2008) Cranberry for UTI prevention in residents of long term care facilities (PACS). <a href="https://clinicaltrials.gov/ct2/show/NCT00596635" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinicaltrials.gov/ct2/show/NCT00596635</a>,
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (trial registration)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct, and Sumit
|
|
D (2014) A Clinical Trial to Determine the Extent to Which Probiotic Therapy Reduces Side Effects of Antibiotic Prophylaxis in Pediatric Neurogenic Bladder Patients With a History of Recurrent Urinary Tract Infections. <a href="http://clinicaltrials.gov/show/NCT02044965" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Http://clinicaltrials.gov/show/NCT02044965</a>,
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (trial registration)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nelson Caleb
|
|
P, Hoberman
|
|
Alejandro, Shaikh
|
|
Nader, Keren
|
|
Ron, Mathews
|
|
Ranjiv, Greenfield Saul
|
|
P, Mattoo Tej
|
|
K, Gotman
|
|
Nathan, Ivanova
|
|
Anastasia, Moxey-Mims
|
|
Marva, Carpenter Myra
|
|
A, and Chesney Russell
|
|
W (2016) Antimicrobial Resistance and Urinary Tract Infection Recurrence. Pediatrics
|
|
137(4), [<a href="/pmc/articles/PMC4811311/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4811311</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26969273" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26969273</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Neveus
|
|
Tryggve, Brandstrom
|
|
Per, Linner
|
|
Tina, Jodal
|
|
Ulf, and Hansson
|
|
Sverker (2012) Parental experiences and preferences regarding the treatment of vesicoureteral reflux. Scandinavian journal of urology and nephrology
|
|
46(1), 26–30
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/22008041" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22008041</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not a relevant study</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nordenstrom
|
|
Josefin, Holmdahl
|
|
Gundela, Brandstrom
|
|
Per, Sixt
|
|
Rune, Stokland
|
|
Eira, Sillen
|
|
Ulla, and Sjostrom
|
|
Sofia (2016) The Swedish infant high-grade reflux trial: Study presentation and vesicoureteral reflux outcome. Journal of pediatric urology, [<a href="https://pubmed.ncbi.nlm.nih.gov/27889221" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27889221</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nordenstrom
|
|
J, Sillen
|
|
U, Holmdahl
|
|
G, Linner
|
|
T, Stokland
|
|
E, and Sjostrom
|
|
S (2016) The Swedish Infant High-grade Reflux Trial -Bladder function. Journal of pediatric urology, [<a href="https://pubmed.ncbi.nlm.nih.gov/27989639" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27989639</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not a relevant study</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Opperman
|
|
E A (2010) Cranberry is not effective for the prevention or treatment of urinary tract infections in individuals with spinal cord injury. Spinal cord
|
|
48(6), 451–6
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/19935757" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19935757</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ostrovsky
|
|
D A (2017) Cranberry Capsules do not Appear to Reduce Bacteriuria and Pyuria in Elderly Women Residing in Nursing Homes. Explore
|
|
13(3), 226–227
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/28433645" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28433645</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (literature review)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Perez-Gaxiola
|
|
G (2011) Review: Antibiotic prophylaxis may not prevent recurrent symptomatic urinary tract infection in children. Archives of Disease in Childhood: Education and Practice Edition
|
|
96(5), 198
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/21576206" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21576206</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abstract only</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Pouwels Koen
|
|
B, Visser Sipke
|
|
T, and Hak
|
|
Eelko (2013) Effect of pravastatin and fosinopril on recurrent urinary tract infections. The Journal of antimicrobial chemotherapy
|
|
68(3), 708–14
|
|
[<a href="/pmc/articles/PMC3566666/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3566666</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23111852" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23111852</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Poor relevance against search terms (interventions)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
British Medical Journal Publishing Group (2013) Prevention of recurrent urinary tract infections in women. Drug and therapeutics bulletin
|
|
51(6), 69–72
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23766394" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23766394</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (literature review)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Rego
|
|
L L, Glazer
|
|
C S, and Zimmern
|
|
P E (2016) Risks of long-term use of nitrofurantoin for urinary tract prophylaxis in the older patient. Urological Science
|
|
27(4), 193–198
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (literature review)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Salo
|
|
J, Kontiokari
|
|
T, Helminen
|
|
M, Korppi
|
|
M, Nieminen
|
|
T, Pokka
|
|
T, and Uhari
|
|
M (2010) Randomized trial of cranberry juice for the prevention of recurrences of urinary tract infections in children. Clinical microbiology and infection
|
|
16(Suppl 2), S385–s386 [<a href="https://pubmed.ncbi.nlm.nih.gov/22100577" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22100577</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Unable to source</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Schaeffer Anthony
|
|
J, Greenfield Saul
|
|
P, Ivanova
|
|
Anastasia, Cui
|
|
Gang, Zerin
|
|
J Michael, Chow Jeanne
|
|
S, Hoberman
|
|
Alejandro, Mathews Ranjiv
|
|
I, Mattoo Tej
|
|
K, Carpenter Myra
|
|
A, Moxey-Mims
|
|
Marva, Chesney Russell
|
|
W, and Nelson Caleb
|
|
P (2016) Reliability of grading of vesicoureteral reflux and other findings on voiding cystourethrography. Journal of pediatric urology, [<a href="/pmc/articles/PMC5339054/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5339054</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27666144" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27666144</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not a relevant study</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Seideman
|
|
C, Lotan
|
|
Y, and Palmer
|
|
L (2015) Cost effectiveness of antimicrobial prophylaxis for children in the RIVUR trial. Journal of urology
|
|
193(4 suppl. 1), e665 [<a href="https://pubmed.ncbi.nlm.nih.gov/29707736" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29707736</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sen
|
|
Ayan (2006) Recurrent cystitis in non-pregnant women. Clinical evidence (15), 2558–64
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/16973094" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16973094</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (review of systematic reviews and RCTs)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Shaikh
|
|
Nader, Hoberman
|
|
Alejandro, Keren
|
|
Ron, Gotman
|
|
Nathan, Docimo Steven G, Mathews Ranjiv, Bhatnagar
|
|
Sonika, Ivanova
|
|
Anastasia, Mattoo Tej K, Moxey-Mims Marva, Carpenter Myra
|
|
A, Pohl Hans
|
|
G, and Greenfield
|
|
Saul (2016) Recurrent Urinary Tract Infections in Children With Bladder and Bowel Dysfunction. Pediatrics
|
|
137(1), [<a href="/pmc/articles/PMC4702025/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4702025</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26647376" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26647376</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Shmuely
|
|
H, Ofek
|
|
I, Weiss
|
|
EI, Rones
|
|
Z, and Houri-Haddad
|
|
Y (2012) Cranberry components for the therapy of infectious disease. Current opinion in biotechnology
|
|
23(2), 148–52
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/22088310" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22088310</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not a clinical study</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Stepanova
|
|
N, Kruglikov
|
|
V, Lebid
|
|
L, and Kolesnyk
|
|
M (2013) Oral lactobacilli vs antibiotic prophylaxis for recurrent urinary tract infections in premenopausal women. European Urology, and Supplements
|
|
12(1), e892
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (literature review)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sumukadas
|
|
D, Davey
|
|
P, and McMurdo
|
|
M E. T (2009) Recurrent urinary tract infections in older people: The role of cranberry products. Age and Ageing
|
|
38(3), 255–257
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/19269945" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19269945</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (commentary)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sung
|
|
Jennifer, and Skoog
|
|
Steven (2012) Surgical management of vesicoureteral reflux in children. Pediatric nephrology (Berlin, and Germany)
|
|
27(4), 551–61 [<a href="/pmc/articles/PMC3288369/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3288369</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/21695451" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21695451</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant population</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Takahashi
|
|
S (2012) Prevention of acute uncomplicated cystitis by cranberry juice. International journal of urology
|
|
19, 410
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abstract only</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Takvani
|
|
A, Gokani
|
|
C, and Malaviya
|
|
P (2015) Vesicoureteric reflux-a prospective study of 11 years. European Urology, and Supplements
|
|
14(2), e505–e505a
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not a relevant study</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Thomas
|
|
J (2011) Cranberry juice fails to prevent recurring urinary tract infections. Australian Journal of Pharmacy
|
|
92(1092), 81
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abstract only</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Uberos
|
|
J, Rodrguez-Belmonte
|
|
R, Fernndez-Puentes
|
|
V, Narbona-Lpez
|
|
E, Molina-Carballo
|
|
A, and Munoz-Hoyos
|
|
A (2010) Cranberry syrup vs. trimethoprim in the prophylaxis of recurrent urinary infection: A double-blind randomized clinical trial. Acta paediatrica
|
|
99(Suppl 462), 48
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abstract only</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Uberos
|
|
J, Fernandez-Puentes
|
|
V, Molina-Oya
|
|
M, Rodriguez-Belmonte
|
|
R, Ruiz-Lopez
|
|
A, Tortosa-Pinto
|
|
P, Molina-Carballo
|
|
A, and Munoz-Hoyos
|
|
A (2012) Urinary excretion of phenolic acids by infants and children: a randomised double-blind clinical assay. Clinical medicine insights. Pediatrics
|
|
6, 67–74
|
|
[<a href="/pmc/articles/PMC3620699/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3620699</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23641168" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23641168</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not a relevant study</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Uehara
|
|
Shinya, Monden
|
|
Koichi, Nomoto
|
|
Koji, Seno
|
|
Yuko, Kariyama
|
|
Reiko, and Kumon
|
|
Hiromi (2006) A pilot study evaluating the safety and effectiveness of Lactobacillus vaginal suppositories in patients with recurrent urinary tract infection. International journal of antimicrobial agents
|
|
28 Suppl 1, S30–4
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/16859900" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16859900</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abstract only</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Vasileiou
|
|
I, Katsargyris
|
|
A, Theocharis
|
|
S, and Giaginis
|
|
C (2013) Current clinical status on the preventive effects of cranberry consumption against urinary tract infections. Nutrition research (New York, and N.Y.)
|
|
33(8), 595–607 [<a href="https://pubmed.ncbi.nlm.nih.gov/23890348" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23890348</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (literature review)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Vicariotto
|
|
Franco (2014) Effectiveness of an association of a cranberry dry extract, D-mannose, and the two microorganisms Lactobacillus plantarum LP01 and Lactobacillus paracasei LPC09 in women affected by cystitis: a pilot study. Journal of clinical gastroenterology
|
|
48 Suppl 1, S96–101
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25291140" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25291140</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (observational study)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Vidlar
|
|
A, Vostalova
|
|
J, Vacek
|
|
J, Kosina
|
|
P, Vrbkova
|
|
J, Ulrichova
|
|
J, Student
|
|
V, and Simanek
|
|
V (2011) The effect of cranberry (Vaccini um macrocarpon) on the recurrence urinary tract infection in women. European Urology, and Supplements
|
|
10(9), 622
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abstract only</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Vostalova
|
|
Jitka, Vidlar
|
|
Ales, Simanek
|
|
Vilim, Galandakova
|
|
Adela, Kosina
|
|
Pavel, Vacek
|
|
Jan, Vrbkova
|
|
Jana, Zimmermann Benno F, Ulrichova Jitka, and Student
|
|
Vladimir (2015) Are High Proanthocyanidins Key to Cranberry Efficacy in the Prevention of Recurrent Urinary Tract Infection?. Phytotherapy research: PTR
|
|
29(10), 1559–67
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/26268913" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26268913</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (literature review)</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wald
|
|
E (2010) Antibiotic prophylaxis can prevent recurrent infection in children with urinary tract infections. Journal of Pediatrics
|
|
156(5), 856–857 [<a href="https://pubmed.ncbi.nlm.nih.gov/20385323" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20385323</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abstract only</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wan
|
|
KS, Liu
|
|
CK, Lee
|
|
WK, Ko
|
|
MC, and Huang
|
|
CS (2016) Cranberries for Preventing Recurrent Urinary Tract Infections in Uncircumcised Boys. Alternative therapies in health and medicine
|
|
22(6), 20–23 [<a href="https://pubmed.ncbi.nlm.nih.gov/27866177" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27866177</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant intervention</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Williams
|
|
GJ, Lee
|
|
A, and Craig
|
|
JC (2001) Long-term antibiotics for preventing recurrent urinary tract infection in children. The Cochrane database of systematic reviews (4), CD001534
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/11687116" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11687116</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Updated systematic review available</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Williams
|
|
GJ, Wei
|
|
L, Lee
|
|
A, and Craig
|
|
JC (2006) Long-term antibiotics for preventing recurrent urinary tract infection in children. The Cochrane database of systematic reviews (3), CD001534
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/16855971" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16855971</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Updated systematic review available</td></tr><tr><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Williams
|
|
GJ, Craig
|
|
JC, and Carapetis
|
|
JR (2013) Preventing urinary tract infections in early childhood. Advances in experimental medicine and biology
|
|
764, 211–8
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23654070" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23654070</span></a>]
|
|
</td><td headers="hd_h_niceng112er1.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication/study type (literature review)</td></tr></tbody></table></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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