Antibiotics efficacy in clinical and microbiological cure of uncomplicated urinary tract infection : a systematic review and network meta-analysis
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature..
PURPOSE: Fosfomycin has been used more frequently in managing uncomplicated urinary tract infections (UTIs) due to decreased compliance and increased multidrug-resistant bacteria. The aim of this network meta-analysis was to assess the efficacy of Fosfomycin compared to Nitrofurantoin, Trimethoprim-Sulfamethoxazole (TMP-SMX), and Ciprofloxacin in terms of clinical and microbiological cure alongside with other measurements.
MATERIALS AND METHODS: We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL). We included randomized control trials (RCTs) with uncomplicated UTI patients who received Fosfomycin, Nitrofurantoin, TMP-SMX, or Ciprofloxacin and reported the clinical or microbiological cure. We used Cochrane Risk of Bias Assessment Tool to assess the included studies' quality. R-software was used for all statistical analysis. We ranked all antibiotics using the netrank function which yielded P scores. Frequentist network meta-analysis was used to assess the efficacy of all outcomes.
RESULTS: We included 13 RCTs with a total number of 3856 patients that showed Fosfomycin ranked the highest among the other antibiotics with respect to clinical cure (P-score = 0.99) and microbiological cure (P-score = 0.99) while Ciprofloxacin ranked the lowest (P-score = 0.11 and 0.02, respectively). Moreover, Ciprofloxacin yielded the highest relapse rate (P-score = 1), whereas TMP-SMX had the lowest relapse rate (P-score = 0.07). As for the adverse events, Ciprofloxacin demonstrated the highest adverse events as opposed to Fosfomycin (P-score = 0.98 and 0.05, respectively).
CONCLUSION: The network meta-analysis demonstrated that Fosfomycin is the most effective antibiotic in treating uncomplicated UTIs with respect to clinical cure, microbiological cure, and adverse events profile.
| Errataetall: |
CommentIn: World J Urol. 2024 Apr 24;42(1):253. - PMID 38656369 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:42 |
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| Enthalten in: |
World journal of urology - 42(2024), 1 vom: 08. Apr., Seite 221 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hadidi, Mohammed F [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 09.04.2024 Date Revised 24.04.2024 published: Electronic CommentIn: World J Urol. 2024 Apr 24;42(1):253. - PMID 38656369 Citation Status MEDLINE |
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| doi: |
10.1007/s00345-024-04922-5 |
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| Förderinstitution / Projekttitel: |
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NLM370770579 |
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| 100 | 1 | |a Hadidi, Mohammed F |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Antibiotics efficacy in clinical and microbiological cure of uncomplicated urinary tract infection |b a systematic review and network meta-analysis |
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| 500 | |a CommentIn: World J Urol. 2024 Apr 24;42(1):253. - PMID 38656369 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. | ||
| 520 | |a PURPOSE: Fosfomycin has been used more frequently in managing uncomplicated urinary tract infections (UTIs) due to decreased compliance and increased multidrug-resistant bacteria. The aim of this network meta-analysis was to assess the efficacy of Fosfomycin compared to Nitrofurantoin, Trimethoprim-Sulfamethoxazole (TMP-SMX), and Ciprofloxacin in terms of clinical and microbiological cure alongside with other measurements | ||
| 520 | |a MATERIALS AND METHODS: We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL). We included randomized control trials (RCTs) with uncomplicated UTI patients who received Fosfomycin, Nitrofurantoin, TMP-SMX, or Ciprofloxacin and reported the clinical or microbiological cure. We used Cochrane Risk of Bias Assessment Tool to assess the included studies' quality. R-software was used for all statistical analysis. We ranked all antibiotics using the netrank function which yielded P scores. Frequentist network meta-analysis was used to assess the efficacy of all outcomes | ||
| 520 | |a RESULTS: We included 13 RCTs with a total number of 3856 patients that showed Fosfomycin ranked the highest among the other antibiotics with respect to clinical cure (P-score = 0.99) and microbiological cure (P-score = 0.99) while Ciprofloxacin ranked the lowest (P-score = 0.11 and 0.02, respectively). Moreover, Ciprofloxacin yielded the highest relapse rate (P-score = 1), whereas TMP-SMX had the lowest relapse rate (P-score = 0.07). As for the adverse events, Ciprofloxacin demonstrated the highest adverse events as opposed to Fosfomycin (P-score = 0.98 and 0.05, respectively) | ||
| 520 | |a CONCLUSION: The network meta-analysis demonstrated that Fosfomycin is the most effective antibiotic in treating uncomplicated UTIs with respect to clinical cure, microbiological cure, and adverse events profile | ||
| 650 | 4 | |a Meta-Analysis | |
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| 700 | 1 | |a Alhakami, Mohammed |e verfasserin |4 aut | |
| 700 | 1 | |a Abdulhamid, Ahmed S |e verfasserin |4 aut | |
| 700 | 1 | |a Alsharif, Abdullah |e verfasserin |4 aut | |
| 700 | 1 | |a Alomari, Mohammed S |e verfasserin |4 aut | |
| 700 | 1 | |a Alghamdi, Yasir A |e verfasserin |4 aut | |
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| 700 | 1 | |a Alsenani, Faisal M |e verfasserin |4 aut | |
| 700 | 1 | |a Almadani, Hisham |e verfasserin |4 aut | |
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