How effective are antibiotics for symptomatic urinary tract infection (UTI) during pregnancy?
All the antibiotics studied were very effective. In most of the comparisons,
there were no significant differences between the treatments
with regard to cure rates, recurrent infection, incidence of
preterm delivery, admission to neonatal intensive care unit, need
for change of antibiotic or incidence of prolonged pyrexia. Complications
were very rare. Antibiotics tested included penicillins,
cephalosporins, aminoglycosides, antimetabolites, nitrofurantoin
and fosfomycin trometamol.
It was not possible to draw reliable conclusions as to which was
the best class, route or regimen of antibiotic to treat symptomatic
UTIs during pregnancy because of limitations in the primary data
(quality and sample sizes). The main problems overall were the
loss to follow-up (between 8% and 25%), performance of late
microbiological studies and follow-up samples, and lack of reporting
of important data about pregnancy outcomes.
Urinary tract infections, including cystitis and pyelonephritis, are
common in pregnancy and are serious complications that may
lead to significant maternal and neonatal morbidity and mortality.
Cochrane Systematic Review:
Vazquez JC and Abalos E. Treatments for symptomatic urinary tract
infections during pregnancy. Cochrane Reviews, 2011, Issue 1.
Art. No. CD002256. DOI: 10.1002/14651858.CD002256.pub2.
This review contains 10 studies involving 1125 participants.