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Treatment of Uncomplicated UTI in Males : a Systematic Review of the Literature

Farrell, Karen ; Tandan, Meera ; Santiago, Virginia Hernandez ; Gagyor, Ildiko ; Braend, Anja Maria ; Skow, Marius ; Vik, Ingvild ; Jansaaker, Filip LU ; Hayward, Gail and Vellinga, Akke (2021) In BJGP open 5(2).
Abstract

Background: Urinary tract infections (UTIs) affect around 20% of the male population in their lifetime. The incidence of UTIs in men in the community is 0.9–2.4 cases per 1000 aged <55 years and 7.7 per 1000 aged ≥85 years. Aim: To evaluate the outcomes of randomised controlled trials (RCTs) comparing the effectiveness of different antimicrobial treatments and durations for uncomplicated UTIs in adult males in outpatient settings. Method: A systematic literature review of RCTs of adult male patients with an uncomplicated UTI treated with oral antimicrobials in any outpatient setting. The outcomes were symptom resolution within 2 weeks of starting treatment, duration until symptom resolution, clinical cure, bacteriological cure, and... (More)

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

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
antibiotic treatment, male, primary health care, randomised clinical trial, review, urinary tract infections
in
BJGP open
volume
5
issue
2
pages
9 pages
publisher
Royal College of General Practitioners
external identifiers
  • scopus:85106633977
  • pmid:33234514
ISSN
2398-3795
DOI
10.3399/bjgpopen20X101140
language
English
LU publication?
yes
id
d581af37-5e66-48f4-9d1f-214e21992e46
date added to LUP
2021-06-14 16:53:46
date last changed
2024-04-20 07:29:35
@article{d581af37-5e66-48f4-9d1f-214e21992e46,
  abstract     = {{<p>Background: Urinary tract infections (UTIs) affect around 20% of the male population in their lifetime. The incidence of UTIs in men in the community is 0.9–2.4 cases per 1000 aged &lt;55 years and 7.7 per 1000 aged ≥85 years. Aim: To evaluate the outcomes of randomised controlled trials (RCTs) comparing the effectiveness of different antimicrobial treatments and durations for uncomplicated UTIs in adult males in outpatient settings. Method: A systematic literature review of RCTs of adult male patients with an uncomplicated UTI treated with oral antimicrobials in any outpatient setting. The outcomes were symptom resolution within 2 weeks of starting treatment, duration until symptom resolution, clinical cure, bacteriological cure, and frequency of adverse events. Results: From the 1052 abstracts screened, three provided sufficient information on outcomes. One study compared trimethoprim-sulfamethoxazole for 14 days (21 males) with 42 days (21 males). Fluoroquinolones were compared in the two other RCTs: lomefloxacin (10 males) with norfloxacin (11 males), and ciprofloxacin for 7 days (19 males) and 14 days (19 males). Combining the results from the three RCTs shows that for 75% males with a UTI (76/101) bacteriological cure was reported at the end of the study. Of the 59 patients receiving a fluoroquinolone, 57 (97%) reported bacteriological and clinical cure within 2 weeks after treatment. Conclusion: The evidence available is insufficient to make any recommendations in relation to type and duration of antimicrobial treatment for male UTIs. Sufficiently powered RCTs are needed to identify best treatment type and duration for male UTIs in primary care.</p>}},
  author       = {{Farrell, Karen and Tandan, Meera and Santiago, Virginia Hernandez and Gagyor, Ildiko and Braend, Anja Maria and Skow, Marius and Vik, Ingvild and Jansaaker, Filip and Hayward, Gail and Vellinga, Akke}},
  issn         = {{2398-3795}},
  keywords     = {{antibiotic treatment; male; primary health care; randomised clinical trial; review; urinary tract infections}},
  language     = {{eng}},
  number       = {{2}},
  publisher    = {{Royal College of General Practitioners}},
  series       = {{BJGP open}},
  title        = {{Treatment of Uncomplicated UTI in Males : a Systematic Review of the Literature}},
  url          = {{http://dx.doi.org/10.3399/bjgpopen20X101140}},
  doi          = {{10.3399/bjgpopen20X101140}},
  volume       = {{5}},
  year         = {{2021}},
}