Previous evidence has found that giving prophylactic antibiotics is more likely to prevent a urinary tract infection than placebo. Of these, 25% experience recurrent infections, defined as at least two infections in six months or three in one year. Around half the women in the UK are likely to have at least one in their life. Urinary tract infections are common and mainly affect women. Some caution should be used in the interpretation of the results as only one of the trials was done in the past ten years, so new data in this area would be useful. Trimethoprim is likely to remain the drug of choice, reserving nitrofurantoin for cases where it is ineffective or not tolerated. It was hoped that this older antibiotic could be a first-line strategy when long-term use is indicated for people with recurrent urinary tract infections. This review of 12 trials, with 1,063 women, compared nitrofurantoin with other antibiotics such as trimethoprim, or oestrogen cream. ![]() The potential for inducing less antibiotic resistance compared to trimethoprim is a potential advantage of nitrofurantoin but this wasn’t a specified outcome for this review. However gastrointestinal side effects were more common in people on nitrofurantoin. The antibiotic nitrofurantoin works as well as other long-term antibiotics for preventing recurrent urinary tract infections in women.
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