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Urinary alkalisation for symptomatic uncomplicated urinary tract infection in women

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References

References to studies excluded from this review

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Brumfitt 1990 {published data only}

Brumfitt W, Hamilton‐Miller J, Cooper J, Raeburn A. Relationship of urinary pH to symptoms of 'cystitis'. Postgraduate Medical Journal 1990;66(779):727‐9. [MEDLINE: 2235803]

Butler 1983 {published data only}

Butler AV, Cullen MJ, Parry MO, Sylvester DG, Speller DC. Acute cystitis in young women. Treatment with citrated nalidixic acid compared with co‐trimoxazole. Practitioner 1983;227(1379):833‐5. [MEDLINE: 6604266]

Carter 1991 {published data only}

Carter P, Lewis P, Abrams P. Urodynamic morbidity and dysuria prophylaxis. British Journal of Urology 1991;67(1):40‐1. [MEDLINE: 1847088]

Darioli 1983 {published data only}

Darioli R, Chappuis P, Dubi J. Evaluation of the treatment of symptomatic urinary tract infection with a single dose of antibiotics or bicarbonate [Evaluation du traitement de l'infection urinaire symptomatique par dose unique d'antibiotiques ou par bicarbonate]. Schweizerische Medizinische Wochenschrift 1983;113(1):14‐6. [MEDLINE: 6298934]

Klastersky 1971 {published data only}

Klastersky J, Debusscher L, Daneau D. Effectiveness of erythromycin plus alkalinization and of nitrofurantoin in the treatment of urinary tract infections. Current Therapeutic Research, Clinical & Experimental 1971;13(7):427‐33. [MEDLINE: 5000295]

Reeves 1984 {published data only}

Reeves DS, Lacey RW, Mummery RV, Mahendra M, Bint AJ, Newsom SW. Treatment of acute urinary infection by norfloxacin or nalidixic acid/citrate: a multi‐centre comparative study. Journal of Antimicrobial Chemotherapy 1984;13 Suppl B:99‐105. [MEDLINE: 6234282]

Additional references

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ACOG 2008

American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 91: Treatment of urinary tract infections in nonpregnant women. Obstetrics & Gynecology 2008;111(3):785‐94. [MEDLINE: 18310389]

Bleidorn 2010

Bleidorn J, Gagyor I, Kochen MM, Wegscheider K, Hummers‐Pradier E. Symptomatic treatment (ibuprofen) or antibiotics (ciprofloxacin) for uncomplicated urinary tract infection?‐‐results of a randomized controlled pilot trial. BMC Medicine 2010;8:30. [MEDLINE: 20504298]

Burian 2012

Burian A, Erdogan Z, Jandrisitis C, Zeitlinger M. Impact of pH on activity of trimethoprim, fosfomycin, amikacin, colistin and ertapenem in human urine. Pharmacology 2012;90(5‐6):281‐7. [MEDLINE: 23037005]

Carlsson 2003

Carlsson S, Govoni M, Wiklund NP, Weitzberg E, Lundberg JO. In vitro evaluation of a new treatment for urinary tract infections caused by nitrate‐reducing bacteria. Antimicrobial Agents & Chemotherapy 2003;47(12):3713‐8. [MEDLINE: 14638471]

eMC 2016

electronic Medicines Compendium (eMC). www.medicines.org.uk/emc (accessed 19 January 2016).

Foxman 2002

Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. American Journal of Medicine 2002;113 Suppl 1A:5S‐13S. [MEDLINE: 12113866]

Foxman 2003

Foxman B, Brown P. Epidemiology of urinary tract infections transmission and risk factors, incidence, and costs. Infectious Disease Clinics of North America 2003;17(2):227‐41. [MEDLINE: 12848468]

Franz 1999

Franz M, Hörl WH. Common errors in diagnosis and management of urinary tract infection. I: pathophysiology and diagnostic techniques. Nephrology Dialysis Transplantation 1999;14(11):2746‐53. [MEDLINE: 10534527]

Grabe 2010

Grabe M, Bjerklund‐Johansen TE, Botto H, Wullt B, Çek M, Naber KG, et al. Guidelines on urological infections. Chapter 3: Uncomplicated UTIs in adults. uroweb.org/wp‐content/uploads/18_Urological‐infections_LR.pdf (accessed 19 January 2016).

Higgins 2003

Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ 2003;327(7414):557‐60. [MEDLINE: 12958120]

Higgins 2011

Higgins JP, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.2.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.

IDSA/ESMI 2011

Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG, 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. Clinical Infectious Diseases 2011;52(5):e103‐20. [MEDLINE: 21292654]

Mazzulli 2002

Mazzulli T. Resistance trends in urinary tract pathogens and impact on management. Journal of Urology 2002;168(4 Pt 2):1720‐2. [MEDLINE: 12352343]

MIMS 2016

Uracol, Citralite, Citravescent sachets, Uricosal. MIMS Australia, 2016. www.mims.com.au/.

Munday 1990

Munday PE, Savage S. Cymalon in the management of urinary tract symptoms. Genitourinary Medicine 1990;66(6):461. [MEDLINE: 2265846]

Murtagh 2015

Murtagh J, Rosenblatt J. Chapter 25 Urinary Tract Infection. Murtagh's General Practice. 6. North Ryde, NSW: McGraw‐Hill Australia, 2015:246. [ISBN: 9781743760031]

Nguan 2005

Nguan C, Franciosi LG, Buherfield NN, Macleod BA, Jens M, Fenster HN. A prospective, double‐blind, randomized cross‐over study evaluating changes in urinary pH for relieving the symptoms of interstitial cystitis. BJU International 2005;95(1):91‐4. [MEDLINE: 15638902]

NICE 2009

National Institute of Health and Care Excellence. Urinary tract infection (lower) ‐ women. NICE Guidelines, 2009. cks.nice.org.uk/urinary‐tract‐infection‐lower‐women (accessed 4 September 2013).

Phelps 2011

Phelps K, Hassed C. Chapter 46: Urology. General Practice. The Integrative Approach. 1. Chatswood, NSW: Elsevier Australia, 2011:662.

Richards 2005

Richards D, Toop L, Chambers S, Fletcher L. Response to antibiotics of women with symptoms of urinary tract infection but negative dipstick urine test results: double blind randomised controlled trial. BMJ 2005;331(7509):143. [MEDLINE: 15972728]

Spooner 1984

Spooner JB. Alkalinisation in the management of cystitis. Journal of International Medical Research 1984;12(1):30‐4. [MEDLINE: 6692966]

Wong 2010

Wong LM, Huang JG, Yong TL, Robertson I, Brough SJ. Does sodium bicarbonate reduce painful voiding after flexible cystoscopy? A prospective, randomized, double‐blind, controlled trial. BJU International 2010;10(5):718‐21. [MEDLINE: 21438987]

Zhanel 1991

Zhanel GG, Karlowsky JA, Davidson RJ, Hoban DJ. Influence of human urine on the in vitro activity and postantibiotic effect of ciprofloxacin against Escherichia coli. Chemotherapy 1991;37(3):218‐23. [MEDLINE: 1889309]

References to other published versions of this review

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O'Kane 2013

O'Kane DB, Dave SK, Gore N, Patel F, Hoffmann T, Del Mar CB. Urinary alkalisation for uncomplicated urinary tract infection. Cochrane Database of Systematic Reviews 2013, Issue 10. [DOI: 10.1002/14651858.CD010745]

Characteristics of studies

Characteristics of excluded studies [ordered by year of study]

Study

Reason for exclusion

Klastersky 1971

This paper compared an antibiotic (erythromycin) in alkaline conditions with a different antibiotic (nitrofurantoin). Although this paper included a urinary alkaliser, the fact that it was coupled with a different antibiotic to the other study arm means that no conclusions on the efficacy of the alkaliser can be made by comparison of these two groups. Furthermore most of the patients in this study had advanced pelvic cancers, some had urological issues, and some had indwelling urinary catheters meaning that they did not meet inclusion criteria for this review.

Darioli 1983

This study compared a single dose of urinary alkaliser with a single dose of an antibiotic. A single dose of an antibiotic is not an accepted treatment for UTI, and therefore is not an appropriate comparison. The aim of this study was actually to investigate the use of a single dose of antibiotic, and the alkaliser arm was acting as a placebo arm. Furthermore a single dose of urinary alkaliser is not an appropriate dose to change urinary pH.

Butler 1983

This paper compared an antibiotic (nalidixic acid) coupled with a urinary alkaliser (citrate) with a different antibiotic (cotrimoxazole). As in the Klastersky 1971 paper above, no conclusions on the efficacy of the urinary alkaliser can be made from comparison of the two arms in this study.

Reeves 1984

Similar to Klastersky 1971 and Butler 1983, this paper compared an antibiotic (nalidixic acid) coupled with a urinary alkaliser (citrate) with a different antibiotic norfloxacin. No conclusions on the efficacy of the urinary alkaliser can be drawn from this comparison.

Brumfitt 1990

This paper reported on the different urinary pHs seen in patients with 'cystitis'. However, there was no intervention, no urinary alkaliser used

Carter 1991

This study reported on the use of urinary alkalisers for prophylaxis against dysuria following urological intervention. Because there was instrumentation of the urethra/bladder in this study the patients were not eligible for inclusion into this review.

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