Cranberry or trimethoprim for the prevention of recurrent urinary tract infections? A randomized controlled trial in older women
Cranberry or trimethoprim for the prevention of recurrent urinary tract infections? A randomized controlled trial in older women
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DOI：
10.1093/jac/dkn489
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发表时间：
2009-02-01
影响因子：
5.2
通讯作者：
Davey, Peter
中科院分区：
文献类型：
--
作者：
McMurdo, Marion E. T.;Argo, Ishbel;Davey, Peter
比较蔓越莓提取物与低剂量甲氧苄啶预防老年女性复发性尿路感染 (UTI) 的有效性。137 名在过去 12 个月内接受过两种或多种抗生素治疗 UTI 的女性被随机分配接受 500 mg 蔓越莓提取物或 100 mg 甲氧苄啶，为期 6 个月。试验注册：ISRCTN80031108。137 名参与者中的 39 名（28%）患有抗生素治疗的 UTI（蔓越莓组 25 名，甲氧苄啶组 14 名）；比例差异相对风险 1.616 (95% CI: 0.93, 2.79) P = 0.084。各组之间首次 UTI 复发的时间没有显着差异 (P = 0.100)。蔓越莓组至 UTI 复发的中位时间为 84.5 天，甲氧苄啶组为 91 天（U = 166，P = 0.479）。有 17/137 (12%) 例退出研究，其中蔓越莓组 6/69 (9%) 和甲氧苄啶组 11/68 (16%) (P = 0.205)，蔓越莓组退出的相对风险为 0.54 (95% CI: 0.19, 1.37)。预防老年女性复发性尿路感染，并产生更多不良影响。我们的研究结果将使患有复发性尿路感染的老年女性能够与临床医生权衡蔓越莓提取物等廉价天然产品的固有吸引力，这种产品的使用不会带来抗菌药物耐药性或艰难梭菌或真菌重复感染的风险。
To compare the effectiveness of cranberry extract with low-dose trimethoprim in the prevention of recurrent urinary tract infections (UTIs) in older women.One hundred and thirty-seven women with two or more antibiotic-treated UTIs in the previous 12 months were randomized to receive either 500 mg of cranberry extract or 100 mg of trimethoprim for 6 months. Trial registration: ISRCTN80031108.Thirty-nine of 137 participants (28%) had an antibiotic-treated UTI (25 in the cranberry group and 14 in the trimethoprim group); difference in proportions relative risk 1.616 (95% CI: 0.93, 2.79) P = 0.084. The time to first recurrence of UTI was not significantly different between the groups (P = 0.100). The median time to recurrence of UTI was 84.5 days for the cranberry group and 91 days for the trimethoprim group (U = 166, P = 0.479). There were 17/137 (12%) withdrawals from the study, 6/69 (9%) from the cranberry group and 11/68 (16%) from the trimethoprim group (P = 0.205), with a relative risk of withdrawal from the cranberry group of 0.54 (95% CI: 0.19, 1.37).Trimethoprim had a very limited advantage over cranberry extract in the prevention of recurrent UTIs in older women and had more adverse effects. Our findings will allow older women with recurrent UTIs to weigh up with their clinicians the inherent attractions of a cheap, natural product like cranberry extract whose use does not carry the risk of antimicrobial resistance or super-infection with Clostridium difficile or fungi.