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Evidence summaries

Nitrofurantoin for Preventing Recurrent Urinary Tract Infection during Pregnancy

There is insufficient evidence on the effect of nitrofurantoin for preventing recurrent urinary tract infection during pregnancy. Level of evidence: "D"

Comment: The quality of evidence is downgraded by study limitations (unclear allocation concealment and blinding, and selective reporting) and by imprecise results (few outcome events and wide confidence intervals).

Summary

A Cochrane review [Abstract] 1 included 1 study with a total of 200 subjects. A daily dose of nitrofurantoin and close surveillance (regular clinic visit, urine cultures and antibiotics when a positive culture was found) was compared with close surveillance only. No significant differences were found for the primary outcomes: recurrent pyelonephritis (RR 0.89, 95% CI 0.31 to 2.53, 1 study, n=167), recurrent urinary tract infection before birth (RR 0.30, 95% CI 0.06 to 1.38; 1 study, n=167) and preterm birth (before 37 weeks) (RR 1.18, 95% CI 0.42 to 3.35; 1 study, n=147). The incidence of asymptomatic bacteriuria (ASB) (at least 103 colonies per mL) (secondary outcome), only reported in women with a clinic attendance rate of more than 90% (RR 0.55, 95% CI 0.34 to 0.89; 1 study, n=102), was significantly reduced in women who received nitrofurantoin and close surveillance.

Clinical comments

Note

Date of latest search:26 July 2015

    References

    • :Schneeberger C, Geerlings SE, Middleton P et al. Interventions for preventing recurrent urinary tract infection during pregnancy. Cochrane Database Syst Rev 2015;(7):CD009279.[PubMed].

Primary/Secondary Keywords