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Research

Treatment of uncomplicated UTI in males: a systematic review of the literature.

Karen Farrell, Meera Tandan, Virginia Hernandez Santiago, Ildiko Gagyor, Anja Maria Braend, Marius Skow, Ingvild Vik, Filip Jansaaker, Gail Hayward and Akke Vellinga
BJGP Open 11 January 2021; bjgpopen20X101140. DOI: https://doi.org/10.3399/bjgpopen20X101140
Karen Farrell
1 General Practice, National University of Ireland Galway, Galway, Ireland
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Meera Tandan
2 University of North Carolina at Chapel Hill Cecil G Sheps Center for Health Services Research, Chapel Hill, United States
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Virginia Hernandez Santiago
3 School of Medicine Medical & Biological Sciences, University of Saint Andrews, Saint Andrews, United Kingdom
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Ildiko Gagyor
4 Dept. of General Practice, Universitatsklinikum Wurzburg, Wurzburg, Germany
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Anja Maria Braend
5 Department of General Practice, University of Oslo Department of Health and Society, Oslo, "Norway
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Marius Skow
6 Department of General Practice, University of Oslo Department of Health and Society, Oslo, "Norway
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Ingvild Vik
7 University of Oslo Department of Health and Society, Oslo, Norway
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Filip Jansaaker
8 Center for Primary Health Care Research, Lund University, Lund, Sweden
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Gail Hayward
9 Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
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Akke Vellinga
10 School of Medicine, National University of Ireland Galway, Galway, Ireland
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  • For correspondence: akke.vellinga@nuigalway.ie
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Abstract

Background: Urinary tract infections (UTI) affect around 20% of the male population in their lifetime. The incidence of UTI in men in the community is 0.9 to 2.4 cases per 1,000 under the age of 55 years and 7.7 per 1,000 over 85 years. Aim: To evaluate the outcomes of randomised controlled trials (RCTs) comparing the effectiveness of different antimicrobial treatments and durations for uncomplicated UTIs in adult males in outpatient settings. Method: RCTs of adult male patients with an uncomplicated UTI treated with oral antimicrobials in any outpatient setting. The outcomes were symptom resolution within two weeks of starting treatment, duration until symptom resolution, clinical cure, bacteriological cure and frequency of adverse events. Results: From the 1041 abstract screened, 3 provided sufficient information on outcomes. One study compared trimethoprim-sulfamethoxazole for 14 days with 42 days in 2*21 males. Fluoroquinolones were compared in the two other studies: lomefloxacin (10 males) with norfloxacin (11 males), and ciprofloxacin for 7 and 14 days (2*19 males). Combining the results from the three studies shows that for 75% males with a UTI (76/101) bacteriological cure was reported at the end of the study. Of the 59 patients receiving a fluoroquinolone, 57 (97%) reported bacteriological and clinical cure within 2 weeks after treatment. Conclusion: The evidence available is insufficient to make any recommendations in relation to type and duration of antimicrobial treatment for male UTIs. Sufficiently powered RCTs are needed to identify best treatment type and duration for male UTIs in primary care.

  • Patient groups
  • Mens health
  • Clinical (physical)
  • Urology
  • Infectious illness
  • Received July 13, 2020.
  • Accepted September 7, 2020.
  • Copyright © 2020, The Authors

This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)

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Accepted Manuscript
Treatment of uncomplicated UTI in males: a systematic review of the literature.
Karen Farrell, Meera Tandan, Virginia Hernandez Santiago, Ildiko Gagyor, Anja Maria Braend, Marius Skow, Ingvild Vik, Filip Jansaaker, Gail Hayward, Akke Vellinga
BJGP Open 11 January 2021; bjgpopen20X101140. DOI: 10.3399/bjgpopen20X101140

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Accepted Manuscript
Treatment of uncomplicated UTI in males: a systematic review of the literature.
Karen Farrell, Meera Tandan, Virginia Hernandez Santiago, Ildiko Gagyor, Anja Maria Braend, Marius Skow, Ingvild Vik, Filip Jansaaker, Gail Hayward, Akke Vellinga
BJGP Open 11 January 2021; bjgpopen20X101140. DOI: 10.3399/bjgpopen20X101140
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Keywords

  • Patient groups
  • Mens health
  • Clinical (physical)
  • Urology
  • Infectious illness

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