Efficacy and safety of oral drugs for uncomplicated lower urinary tract infection in females: a network meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

GUO Wei ^1,2 , GUO Xiang ² , ZHU Lanlan ¹ , LV Jia ¹ ,  HU Pingcheng ¹

1. Department of Epidemiology and Health Statistics, School of Xiangya Public Health, Central South University, Changsha, 410078, P.R.China;
2. Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, 518020, P.R.China;

Corresponding author：

HU Pingcheng, Email: hupingcheng@sina.com

Keywords：

Urinary tract infection; Oral drug; Randomized controlled trail; Network meta-analysis; Efficacy; Safety

DOI：

10.7507/1672-2531.201812134

Video：

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Objectives To systematically review the efficacy and safety of oral drugs for treating women with uncomplicated lower urinary tract infection.Methods PubMed, The Cochrane Library, EMbase, CBM, WanFang Data, CNKI and VIP databases were electronically searched to collect randomized controlled trials (RCTs) of oral drugs for treating females with uncomplicated lower urinary tract infection from inception to November, 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, network meta-analysis was performed by using " gemtc” packages in R 3.5.1 software.Results A total of 38 RCTs were included. The results of network meta-analysis showed that: quinolones (RR=1.24, 95%CI 1.11 to 1.37), furantoin (RR=1.21, 95%CI 1.06 to 1.37), trimethoprim-sulfamethoxazole (TMP-SMZ) (RR=1.20, 95%CI 1.06 to 1.35), fosfomycin (RR=1.17, 95%CI 1.04 to 1.31) and penicillin (RR=1.18, 95%CI 1.05 to 1.33) were superior to non-steroidal anti-inflammatory drugs (NSAIDS) in clinical cure. Quinolones were better than fosfomycin (RR=1.07, 95%CI 1.03 to 1.12), penicillin (RR=1.18, 95%CI 1.13 to 1.23) and cephalosporin (RR=1.13, 95%CI 1.08 to 1.19); furantoin was better than penicillin (RR=1.15, 95%CI 1.08 to 1.21) and cephalosporin (RR=1.10, 95%CI 1.04 to 1.17); TMP-SMZ was better than penicillin (RR=1.15, 95%CI 1.09 to 1.21) and cephalosporin (RR=1.11, 95%CI 1.04 to 1.16); fosfomycin was better than penicillin (RR=1.10, 95%CI 1.04 to 1.16) in bacteriological cure. The adverse effect rates of quinolones were lower than furantoin (RR=0.83, 95%CI 0.70 to 0.98), TMP-SMZ (RR=0.88, 95%CI 0.78 to 0.99) and fosfomycin (RR=0.74, 95%CI 0.59 to 0.93), and which of fosfomycin was higher than penicillin (RR=1.33, 95%CI 1.01 to 1.74) and NSAIDS (RR=1.46, 95%CI 1.11 to 1.92). All differences were statistically significant.Conclusions Current evidence shows that uncomplicated lower urinary tract infection should be recommended to therapy containing quinolones. Due to limited quality and quantity of included studies, more high-quality studies are required to verify the above conclusion.

Citation： GUO Wei, GUO Xiang, ZHU Lanlan, LV Jia, HU Pingcheng. Efficacy and safety of oral drugs for uncomplicated lower urinary tract infection in females: a network meta-analysis. Chinese Journal of Evidence-Based Medicine, 2019, 19(9): 1051-1062. doi: 10.7507/1672-2531.201812134 Copy

1.	Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Am J Med, 2002, 113(Suppl 1A): 5S-13S.
2.	Petersen I, Hayward AC. Antibacterial prescribing in primary care. J Antimicrob Chemother, 2007, 60(Suppl 1): i43-i47.
3.	Zalmanovici TA, Green H, Paul M, et al. Antimicrobial agents for treating uncomplicated urinary tract infection in women. Cochrane Database Syst Rev, 2010, (10): CD007182.
4.	Falagas ME, Vouloumanou EK, Togias AG, et al. Fosfomycin versus other antibiotics for the treatment of cystitis: a meta-analysis of randomized controlled trials. J Antimicrob Chemother, 2010, 65(9): 1862-1877.
5.	田金徽, 李伦. 网状 Meta 分析: 方法与实践. 北京: 中国医药科技出版社, 2017: 107.
6.	Veroniki AA, Vasiliadis HS, Higgins JP, et al. Evaluation of inconsistency in networks of interventions. Int J Epidemiol, 2013, 42(1): 332-345.
7.	Huttner A, Kowalczyk A, Turjeman A, et al. Effect of 5-day nitrofurantoin vs single-dose fosfomycin on clinical resolution of uncomplicated lower urinary tract infection in women: a randomized clinical trial. JAMA, 2018, 319(17): 1781-1789.
8.	Bjerrum L, Gahrn-Hansen B, Grinsted P. Pivmecillinam versus sulfamethizole for short-term treatment of uncomplicated acute cystitis in general practice: a randomized controlled trial. Scand J Prim Health Care, 2009, 27(1): 6-11.
9.	Bleidorn J, Gágyor I, Kochen MM, et al. Symptomatic treatment (ibuprofen) or antibiotics (ciprofloxacin) for uncomplicated urinary tract infection?--results of a randomized controlled pilot trial. BMC Med, 2010, 8: 30.
10.	Block JM, Walstad RA, Bjertnaes A, et al. Ofloxacin versus trimethoprim-sulphamethoxazole in acute cystitis. Drugs, 1987, 34(Suppl 1): 100-106.
11.	Boerema JB, Willems FT. Fosfomycin trometamol in a single dose versus norfloxacin for seven days in the treatment of uncomplicated urinary infections in general practice. Infection, 1990, 18(Suppl 2): S80-S88.
12.	Crocchiolo P. Single-dose fosfomycin trometamol versus multiple-dose cotrimoxazole in the treatment of lower urinary tract infections in general practice. Multicenter Group of General Practitioners. Chemotherapy, 1990, 36(Suppl 1): 37-40.
13.	Elhanan G, Tabenkin H, Yahalom R, et al. Single-dose fosfomycin trometamol versus 5-day cephalexin regimen for treatment of uncomplicated lower urinary tract infections in women. Antimicrob Agents Chemother, 1994, 38(11): 2612-2614.
14.	Goldstein EJ, Alpert ML, Ginsberg BP. Norfloxacin versus trimethoprim-sulfamethoxazole in the therapy of uncomplicated, community-acquired urinary tract infections. Antimicrob Agents Chemother, 1985, 27(3): 422-423.
15.	Greenberg RN, Reilly PM, Luppen KL, et al. Randomized study of single-dose, three-day, and seven-day treatment of cystitis in women. J Infect Dis, 1986, 153(2): 277-282.
16.	Gupta K, Hooton TM, Roberts PL, et al. Short-course nitrofurantoin for the treatment of acute uncomplicated cystitis in women. Arch Intern Med, 2007, 167(20): 2207-2212.
17.	Guttmann D. A comparison of pivmecillinam and cotrimoxazole in the treatment of simple cystitis in general practice. J Antimicrob Chemother, 1977, 3(Suppl B): 137-140.
18.	Henry NK, Schultz HJ, Grubbs NC, et al. Comparison of ciprofloxacin and co-trimoxazole in the treatment of uncomplicated urinary tract infection in women. J Antimicrob Chemother, 1986, 18(Suppl D): 103-106.
19.	Hooton TM, Scholes D, Gupta K, et al. Amoxicillin-clavulanate vs ciprofloxacin for the treatment of uncomplicated cystitis in women: a randomized trial. JAMA, 2005, 293(8): 949-955.
20.	Hooton TM, Roberts PL, Stapleton AE. Cefpodoxime vs. ciprofloxacin for short-course treatment of acute uncomplicated cystitis: a randomized trial. JAMA, 2012, 307(6): 583-589.
21.	Gágyor I, Bleidorn J, Kochen MM, et al. Ibuprofen versus fosfomycin for uncomplicated urinary tract infection in women: randomised controlled trial. BMJ, 2015, 351: h6544.
22.	Vik I, Bollestad M, Grude N, et al. Ibuprofen versus pivmecillinam for uncomplicated urinary tract infection in women-A double-blind, randomized non-inferiority trial. PLoS Med, 2018, 15(5): e1002569.
23.	de Jong Z, Pontonnier F, Plante P. Single-dose fosfomycin trometamol (Monuril) versus multiple-dose norfloxacin: results of a multicenter study in females with uncomplicated lower urinary tract infections. Urol Int, 1991, 46(4): 344-348.
24.	Kavatha D, Giamarellou H, Alexiou Z, et al. Cefpodoxime-proxetil versus trimethoprim-sulfamethoxazole for short-term therapy of uncomplicated acute cystitis in women. Antimicrob Agents Chemother, 2003, 47(3): 897-900.
25.	Kronenberg A, Butikofer L, Odutayo A, et al. Symptomatic treatment of uncomplicated lower urinary tract infections in the ambulatory setting: randomised, double blind trial. BMJ, 2017, 359: j4784.
26.	Menday AP. Comparison of pivmecillinam and cephalexin in acute uncomplicated urinary tract infection. Int J Antimicrob Agents, 2000, 13(3): 183-187.
27.	Naber KG, Koch EM. Cefuroxime axetil versus ofloxacin for short-term therapy of acute uncomplicated lower urinary tract infections in women. Infection, 1993, 21(1): 34-39.
28.	Neu HC. Fosfomycin trometamol versus amoxycillin--single-dose multicenter study of urinary tract infections. Chemotherapy, 1990, 36(Suppl 1): 19-23.
29.	Nicolle LE, Madsen KS, Debeeck GO, et al. Three days of pivmecillinam or norfloxacin for treatment of acute uncomplicated urinary infection in women. Scand J Infect Dis, 2002, 34(7): 487-492.
30.	Nicolle LE, Hoepelman AI, Floor M, et al. Comparison of three days' therapy with cefcanel or amoxicillin for the treatment of acute uncomplicated urinary tract infection. Scand J Infect Dis, 1993, 25(5): 631-637.
31.	Park J, Min K, Kang D. The efficacy and safety of a once-daily extended-release ciprofloxacin tablet for the empirical treatment of symptomatic uncomplicated cystitis in Korean women. Kor J Urol, 2007, 48(1): 35-39.
32.	Van Pienbroek E, Hermans J, Kaptein AA, et al. Fosfomycin trometamol in a single dose versus seven days nitrofurantoin in the treatment of acute uncomplicated urinary tract infections in women. Pharm World Sci, 1993, 15(6): 257-262.
33.	Reynaert J, Van Eyck D, Vandepitte J. Single dose fosfomycin trometamol versus multiple dose norfloxacin over three days for uncomplicated UTI in general practice. Infection, 1990, 18(Suppl 2): S77-S79.
34.	Richaud C. Single dose treatment of lower urinary tract infection in women: results of a trial with fosfomycin trometamol versus pefloxacin. Med Mal Infect, 1995, 25(2): 154-159.
35.	Selvaggi FP, Ditonno P, Traficante A, et al. Fosfomycin trometamol (Monuril) versus norfloxacin in single dose for adult female uncomplicated UTIs. Multicenter randomized, double-blind study. Chemotherapy, 19990, 36(Suppl 1): 31-33.
36.	Stein GE. Comparison of single-dose fosfomycin and a 7-day course of nitrofurantoin in female patients with uncomplicated urinary tract infection. Clin Ther, 1999, 21(11): 1864-1872.
37.	Boyko EJ, Iravani A, Silverman MH, et al. Randomized, controlled trial of a 10-day course of amifloxacin versus trimethoprim-sulfamethoxazole in the treatment of acute, uncomplicated urinary tract infection. Amifloxacin Multi-Center Trial Group. Antimicrob Agents Chemother, 1990, 34(4): 665-667.
38.	Goto T, Kitagawa T, Kawahara M, et al. Comparative study of single-dose and three-day therapy for acute uncomplicated cystitis. Hinyokika Kiyo, 1999, 45(2): 85-89.
39.	Hooton TM, Latham RH, Wong ES, et al. Ofloxacin versus trimethoprim-sulfamethoxazole for treatment of acute cystitis. Antimicrob Agents Chemother, 1989, 33(8): 1308-1312.
40.	Hooton TM, Winter C, Tiu F, et al. Randomized comparative trial and cost analysis of 3-day antimicrobial regimens for treatment of acute cystitis in women. JAMA, 1995, 273(1): 41-45.
41.	Iravani A, Klimberg I, Briefer C, et al. A trial comparing low-dose, short-course ciprofloxacin and standard 7 day therapy with co-trimoxazole or nitrofurantoin in the treatment of uncomplicated urinary tract infection. J Antimicrob Chemother, 1999, 43(Suppl A): 67-75.
42.	McCarty JM, Richard G, Huck W, et al. A randomized trial of short-course ciprofloxacin, ofloxacin, or trimethoprim/sulfamethoxazole for the treatment of acute urinary tract infection in women. Ciprofloxacin Urinary Tract Infection Group. Am J Med, 1999, 106(3): 292-299.
43.	Naber KG, Thyroff-Friesinger U. Fosfomycin trometamol versus ofloxacin/co-trimoxazole as single dose therapy of acute uncomplicated urinary tract infection in females: a multicentre study. Infection, 1990, 18(Suppl 2): S70-S76.
44.	Spencer RC, Moseley DJ, Greensmith MJ. Nitrofurantoin modified release versus trimethoprim or co-trimoxazole in the treatment of uncomplicated urinary tract infection in general practice. J Antimicrob Chemother, 1994, 33(Suppl A): 121-129.
45.	Hooton TM. Clinical practice. Uncomplicated urinary tract infection. N Engl J Med, 2012, 366(11): 1028-1037.
46.	Hooton TM, Stamm WE. Diagnosis and treatment of uncomplicated urinary tract infection. Infect Dis Clin North Am, 1997, 11(3): 551-581.
47.	Falagas ME, Kotsantis IK, Vouloumanou EK, et al. Antibiotics versus placebo in the treatment of women with uncomplicated cystitis: a meta-analysis of randomized controlled trials. J Infect, 2009, 58(2): 91-102.
48.	卫计委合理用药专家委员会办公室. 2017 年全国细菌耐药监测报告. Available at: http://www.carss.cn/Report/Details?aId=552.
49.	Gupta K, Hooton TM, Stamm WE. Increasing antimicrobial resistance and the management of uncomplicated community-acquired urinary tract infections. Ann Intern Med, 2001, 135(1): 41-50.
50.	Sanchez GV, Master RN, Bordon J. Trimethoprim-sulfamethoxazole may no longer be acceptable for the treatment of acute uncomplicated cystitis in the United States. Clin Infect Dis, 2011, 53(3): 316-317.
51.	Oteo J, Bautista V, Lara N, et al. Parallel increase in community use of fosfomycin and resistance to fosfomycin in extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli. J Antimicrob Chemother, 2010, 65(11): 2459-2463.
52.	Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis, 2011, 52(5): e103-e120.
53.	罗伟华. 浅析我国抗生素滥用的现状及对策研究. 北方药学, 2013, 10(11): 85-86.
54.	陈冠容. 重新认识呋喃妥因在治疗非复杂性尿路感染中的重要地位. 医药导报, 2017, 36(9): 962-966.
55.	徐教睿. 口服磷霉素氨基丁三醇治疗尿路感染. 中国医院药学杂志, 2014, 34(3): 244-246.
56.	Rafalsky V, Andreeva I, Rjabkova E. Quinolones for uncomplicated acute cystitis in women. Cochrane Database Syst Rev, 2006, (3): CD003597.

1. Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Am J Med, 2002, 113(Suppl 1A): 5S-13S.
2. Petersen I, Hayward AC. Antibacterial prescribing in primary care. J Antimicrob Chemother, 2007, 60(Suppl 1): i43-i47.
3. Zalmanovici TA, Green H, Paul M, et al. Antimicrobial agents for treating uncomplicated urinary tract infection in women. Cochrane Database Syst Rev, 2010, (10): CD007182.
4. Falagas ME, Vouloumanou EK, Togias AG, et al. Fosfomycin versus other antibiotics for the treatment of cystitis: a meta-analysis of randomized controlled trials. J Antimicrob Chemother, 2010, 65(9): 1862-1877.
5. 田金徽, 李伦. 网状 Meta 分析: 方法与实践. 北京: 中国医药科技出版社, 2017: 107.
6. Veroniki AA, Vasiliadis HS, Higgins JP, et al. Evaluation of inconsistency in networks of interventions. Int J Epidemiol, 2013, 42(1): 332-345.
7. Huttner A, Kowalczyk A, Turjeman A, et al. Effect of 5-day nitrofurantoin vs single-dose fosfomycin on clinical resolution of uncomplicated lower urinary tract infection in women: a randomized clinical trial. JAMA, 2018, 319(17): 1781-1789.
8. Bjerrum L, Gahrn-Hansen B, Grinsted P. Pivmecillinam versus sulfamethizole for short-term treatment of uncomplicated acute cystitis in general practice: a randomized controlled trial. Scand J Prim Health Care, 2009, 27(1): 6-11.
9. Bleidorn J, Gágyor I, Kochen MM, et al. Symptomatic treatment (ibuprofen) or antibiotics (ciprofloxacin) for uncomplicated urinary tract infection?--results of a randomized controlled pilot trial. BMC Med, 2010, 8: 30.
10. Block JM, Walstad RA, Bjertnaes A, et al. Ofloxacin versus trimethoprim-sulphamethoxazole in acute cystitis. Drugs, 1987, 34(Suppl 1): 100-106.
11. Boerema JB, Willems FT. Fosfomycin trometamol in a single dose versus norfloxacin for seven days in the treatment of uncomplicated urinary infections in general practice. Infection, 1990, 18(Suppl 2): S80-S88.
12. Crocchiolo P. Single-dose fosfomycin trometamol versus multiple-dose cotrimoxazole in the treatment of lower urinary tract infections in general practice. Multicenter Group of General Practitioners. Chemotherapy, 1990, 36(Suppl 1): 37-40.
13. Elhanan G, Tabenkin H, Yahalom R, et al. Single-dose fosfomycin trometamol versus 5-day cephalexin regimen for treatment of uncomplicated lower urinary tract infections in women. Antimicrob Agents Chemother, 1994, 38(11): 2612-2614.
14. Goldstein EJ, Alpert ML, Ginsberg BP. Norfloxacin versus trimethoprim-sulfamethoxazole in the therapy of uncomplicated, community-acquired urinary tract infections. Antimicrob Agents Chemother, 1985, 27(3): 422-423.
15. Greenberg RN, Reilly PM, Luppen KL, et al. Randomized study of single-dose, three-day, and seven-day treatment of cystitis in women. J Infect Dis, 1986, 153(2): 277-282.
16. Gupta K, Hooton TM, Roberts PL, et al. Short-course nitrofurantoin for the treatment of acute uncomplicated cystitis in women. Arch Intern Med, 2007, 167(20): 2207-2212.
17. Guttmann D. A comparison of pivmecillinam and cotrimoxazole in the treatment of simple cystitis in general practice. J Antimicrob Chemother, 1977, 3(Suppl B): 137-140.
18. Henry NK, Schultz HJ, Grubbs NC, et al. Comparison of ciprofloxacin and co-trimoxazole in the treatment of uncomplicated urinary tract infection in women. J Antimicrob Chemother, 1986, 18(Suppl D): 103-106.
19. Hooton TM, Scholes D, Gupta K, et al. Amoxicillin-clavulanate vs ciprofloxacin for the treatment of uncomplicated cystitis in women: a randomized trial. JAMA, 2005, 293(8): 949-955.
20. Hooton TM, Roberts PL, Stapleton AE. Cefpodoxime vs. ciprofloxacin for short-course treatment of acute uncomplicated cystitis: a randomized trial. JAMA, 2012, 307(6): 583-589.
21. Gágyor I, Bleidorn J, Kochen MM, et al. Ibuprofen versus fosfomycin for uncomplicated urinary tract infection in women: randomised controlled trial. BMJ, 2015, 351: h6544.
22. Vik I, Bollestad M, Grude N, et al. Ibuprofen versus pivmecillinam for uncomplicated urinary tract infection in women-A double-blind, randomized non-inferiority trial. PLoS Med, 2018, 15(5): e1002569.
23. de Jong Z, Pontonnier F, Plante P. Single-dose fosfomycin trometamol (Monuril) versus multiple-dose norfloxacin: results of a multicenter study in females with uncomplicated lower urinary tract infections. Urol Int, 1991, 46(4): 344-348.
24. Kavatha D, Giamarellou H, Alexiou Z, et al. Cefpodoxime-proxetil versus trimethoprim-sulfamethoxazole for short-term therapy of uncomplicated acute cystitis in women. Antimicrob Agents Chemother, 2003, 47(3): 897-900.
25. Kronenberg A, Butikofer L, Odutayo A, et al. Symptomatic treatment of uncomplicated lower urinary tract infections in the ambulatory setting: randomised, double blind trial. BMJ, 2017, 359: j4784.
26. Menday AP. Comparison of pivmecillinam and cephalexin in acute uncomplicated urinary tract infection. Int J Antimicrob Agents, 2000, 13(3): 183-187.
27. Naber KG, Koch EM. Cefuroxime axetil versus ofloxacin for short-term therapy of acute uncomplicated lower urinary tract infections in women. Infection, 1993, 21(1): 34-39.
28. Neu HC. Fosfomycin trometamol versus amoxycillin--single-dose multicenter study of urinary tract infections. Chemotherapy, 1990, 36(Suppl 1): 19-23.
29. Nicolle LE, Madsen KS, Debeeck GO, et al. Three days of pivmecillinam or norfloxacin for treatment of acute uncomplicated urinary infection in women. Scand J Infect Dis, 2002, 34(7): 487-492.
30. Nicolle LE, Hoepelman AI, Floor M, et al. Comparison of three days' therapy with cefcanel or amoxicillin for the treatment of acute uncomplicated urinary tract infection. Scand J Infect Dis, 1993, 25(5): 631-637.
31. Park J, Min K, Kang D. The efficacy and safety of a once-daily extended-release ciprofloxacin tablet for the empirical treatment of symptomatic uncomplicated cystitis in Korean women. Kor J Urol, 2007, 48(1): 35-39.
32. Van Pienbroek E, Hermans J, Kaptein AA, et al. Fosfomycin trometamol in a single dose versus seven days nitrofurantoin in the treatment of acute uncomplicated urinary tract infections in women. Pharm World Sci, 1993, 15(6): 257-262.
33. Reynaert J, Van Eyck D, Vandepitte J. Single dose fosfomycin trometamol versus multiple dose norfloxacin over three days for uncomplicated UTI in general practice. Infection, 1990, 18(Suppl 2): S77-S79.
34. Richaud C. Single dose treatment of lower urinary tract infection in women: results of a trial with fosfomycin trometamol versus pefloxacin. Med Mal Infect, 1995, 25(2): 154-159.
35. Selvaggi FP, Ditonno P, Traficante A, et al. Fosfomycin trometamol (Monuril) versus norfloxacin in single dose for adult female uncomplicated UTIs. Multicenter randomized, double-blind study. Chemotherapy, 19990, 36(Suppl 1): 31-33.
36. Stein GE. Comparison of single-dose fosfomycin and a 7-day course of nitrofurantoin in female patients with uncomplicated urinary tract infection. Clin Ther, 1999, 21(11): 1864-1872.
37. Boyko EJ, Iravani A, Silverman MH, et al. Randomized, controlled trial of a 10-day course of amifloxacin versus trimethoprim-sulfamethoxazole in the treatment of acute, uncomplicated urinary tract infection. Amifloxacin Multi-Center Trial Group. Antimicrob Agents Chemother, 1990, 34(4): 665-667.
38. Goto T, Kitagawa T, Kawahara M, et al. Comparative study of single-dose and three-day therapy for acute uncomplicated cystitis. Hinyokika Kiyo, 1999, 45(2): 85-89.
39. Hooton TM, Latham RH, Wong ES, et al. Ofloxacin versus trimethoprim-sulfamethoxazole for treatment of acute cystitis. Antimicrob Agents Chemother, 1989, 33(8): 1308-1312.
40. Hooton TM, Winter C, Tiu F, et al. Randomized comparative trial and cost analysis of 3-day antimicrobial regimens for treatment of acute cystitis in women. JAMA, 1995, 273(1): 41-45.
41. Iravani A, Klimberg I, Briefer C, et al. A trial comparing low-dose, short-course ciprofloxacin and standard 7 day therapy with co-trimoxazole or nitrofurantoin in the treatment of uncomplicated urinary tract infection. J Antimicrob Chemother, 1999, 43(Suppl A): 67-75.
42. McCarty JM, Richard G, Huck W, et al. A randomized trial of short-course ciprofloxacin, ofloxacin, or trimethoprim/sulfamethoxazole for the treatment of acute urinary tract infection in women. Ciprofloxacin Urinary Tract Infection Group. Am J Med, 1999, 106(3): 292-299.
43. Naber KG, Thyroff-Friesinger U. Fosfomycin trometamol versus ofloxacin/co-trimoxazole as single dose therapy of acute uncomplicated urinary tract infection in females: a multicentre study. Infection, 1990, 18(Suppl 2): S70-S76.
44. Spencer RC, Moseley DJ, Greensmith MJ. Nitrofurantoin modified release versus trimethoprim or co-trimoxazole in the treatment of uncomplicated urinary tract infection in general practice. J Antimicrob Chemother, 1994, 33(Suppl A): 121-129.
45. Hooton TM. Clinical practice. Uncomplicated urinary tract infection. N Engl J Med, 2012, 366(11): 1028-1037.
46. Hooton TM, Stamm WE. Diagnosis and treatment of uncomplicated urinary tract infection. Infect Dis Clin North Am, 1997, 11(3): 551-581.
47. Falagas ME, Kotsantis IK, Vouloumanou EK, et al. Antibiotics versus placebo in the treatment of women with uncomplicated cystitis: a meta-analysis of randomized controlled trials. J Infect, 2009, 58(2): 91-102.
48. 卫计委合理用药专家委员会办公室. 2017 年全国细菌耐药监测报告. Available at: http://www.carss.cn/Report/Details?aId=552.
49. Gupta K, Hooton TM, Stamm WE. Increasing antimicrobial resistance and the management of uncomplicated community-acquired urinary tract infections. Ann Intern Med, 2001, 135(1): 41-50.
50. Sanchez GV, Master RN, Bordon J. Trimethoprim-sulfamethoxazole may no longer be acceptable for the treatment of acute uncomplicated cystitis in the United States. Clin Infect Dis, 2011, 53(3): 316-317.
51. Oteo J, Bautista V, Lara N, et al. Parallel increase in community use of fosfomycin and resistance to fosfomycin in extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli. J Antimicrob Chemother, 2010, 65(11): 2459-2463.
52. Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis, 2011, 52(5): e103-e120.
53. 罗伟华. 浅析我国抗生素滥用的现状及对策研究. 北方药学, 2013, 10(11): 85-86.
54. 陈冠容. 重新认识呋喃妥因在治疗非复杂性尿路感染中的重要地位. 医药导报, 2017, 36(9): 962-966.
55. 徐教睿. 口服磷霉素氨基丁三醇治疗尿路感染. 中国医院药学杂志, 2014, 34(3): 244-246.
56. Rafalsky V, Andreeva I, Rjabkova E. Quinolones for uncomplicated acute cystitis in women. Cochrane Database Syst Rev, 2006, (3): CD003597.

Chinese Journal of Evidence-Based Medicine

Efficacy and safety of oral drugs for uncomplicated lower urinary tract infection in females: a network meta-analysis

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