Skip to main content
Evidence-Based Supplement Research
Evidence-Based Supplement Research
Pillser
Search
Sign UpLog In

Nonantibiotic prophylaxis for urinary tract infections: a network meta-analysis of randomized controlled trials.

  • 2024-08-02
  • Infection 53(2)
    • Zeyu Han
    • Xianyanling Yi
    • Jin Li
    • Dazhou Liao
    • Jianzhong Ai

Study Design

Type
Systematic Review
Sample size
n = 495
Population
50 RCTs comprising 10,495 subjects
Methods
systematically searched databases for eligible studies; inclusion criteria encompassed RCTs focusing on one or more nonantibiotic interventions for UTI prevention; subgroup analyses by age, sex, and follow-up
Blinding
Double-blind
Funding
Unclear

Objective

Recent guidelines indicated that, in addition to antibiotics, nonantibiotic interventions serve as available preventive options for urinary tract infections (UTIs). This study aimed to compare the efficacy and safety of various nonantibiotic interventions in preventing UTIs.

Methods

The authors systematically searched databases for eligible studies. The inclusion criteria encompassed randomized controlled trials (RCTs) focusing on one or more nonantibiotic interventions for UTI prevention, with the incidence of UTIs being a key outcome measure. Subgroup analyses were performed according to age, sex, and follow-up.

Results

50 RCTs comprising 10,495 subjects and investigating 14 interventions, were included. Nearly 80% of the RCTs utilized double-blind or triple-blind designs. In the whole group, D-mannose (risk ratio [RR] 0.34, 0.21 to 0.56), vaccine (RR 0.65, 0.52 to 0.82), probiotics (RR 0.69, 0.50 to 0.94), cranberry (RR 0.72, 0.60 to 0.87), and triple therapy (cranberry plus probiotics plus vitamin A) (RR 0.27, 0.09 to 0.87), exhibited a significant reduction in UTI incidence compared to the placebo. Probiotics (RR 0.50, 0.28 to 0.89) were the most effective in the nonadult group, while vitamin D (RR 0.46, 0.27 to 0.81) showed the highest efficacy in the long follow-up group (≥ 1 year). There was no significant difference in the incidence of adverse events between the interventions and the placebo group.

Conclusions

D-mannose, triple therapy, vaccine, probiotics, and cranberry serve as potential nonantibiotic intervention options for clinical UTI prevention.

Research Insights

  • Cranberry→Reduced Urinary Tract Infection

    triple therapy (cranberry plus probiotics plus vitamin A) (RR 0.27, 0.09 to 0.87), exhibited a significant reduction in UTI incidence compared to the placebo.

    Effect
    Beneficial
    Effect size
    Large
  • Vitamin A→Reduced Urinary Tract Infection

    triple therapy (cranberry plus probiotics plus vitamin A) (RR 0.27, 0.09 to 0.87), exhibited a significant reduction in UTI incidence compared to the placebo.

    Effect
    Beneficial
    Effect size
    Large
  • Vitamin D→Reduced Urinary Tract Infection

    triple therapy (cranberry plus probiotics plus vitamin A) (RR 0.27, 0.09 to 0.87), exhibited a significant reduction in UTI incidence compared to the placebo.

    Effect
    Beneficial
    Effect size
    Large

Adverse Events Reported

  • Cranberry→Overall tolerability

    There was no significant difference in the incidence of adverse events between the interventions and the placebo group.

    Finding
    No significant difference
    Significant
    No
  • Vitamin D→Overall tolerability

    There was no significant difference in the incidence of adverse events between the interventions and the placebo group.

    Finding
    No significant difference
    Significant
    No
  • Vitamin A→Overall tolerability

    There was no significant difference in the incidence of adverse events between the interventions and the placebo group.

    Finding
    No significant difference
    Significant
    No
Back to top