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Evidence summaries

Treatments for Symptomatic Urinary Tract Infections during Pregnancy

There appear to be no significant differences in effectiveness between different antibiotics used for urinary tract infections during pregnancy. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 10 studies with a total of 1 125 pregnant women. In most of the comparisons there were no significant differences between the treatments (e.g. cefuroxime, ampicillin, nitrofurantoin, fosfomycin) under study with regard to cure rates, recurrent infection, incidence of preterm delivery, admission to neonatal intensive care unit, need for change of antibiotic and incidence of prolonged pyrexia. When cefuroxime and cephradine were compared, there were better cure rates (29/49 versus 41/52) and fewer recurrences (20/49 versus 11/52) in the cefuroxime group, but the sample size is insufficient to ensure that differences found in the effect of the drugs were real. There was only one other statistically significant difference when comparing outpatient versus inpatient treatment. Gestational age at birth was greater in women from the outpatient group (38.86 versus 37.21), while birthweight was on average greater in the inpatient group (3 120 versus 2 659).

Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison).

References

  • Vazquez JC, Abalos E. Treatments for symptomatic urinary tract infections during pregnancy. Cochrane Database Syst Rev 2011;(1):CD002256. [PubMed].

Primary/Secondary Keywords