Probiotics for preventing urinary tract infections in adults and children

Erin M Schwenger; Aaron M Tejani; Peter S Loewen

doi:10.1002/14651858.CD008772.pub2

Scolaris Content Display Scolaris Content Display

Contenido relacionado

Ir a:

Revisiones y protocolos relacionados
Guías
Temas

Revisiones y protocolos relacionados

Topics

Temas

Figure 1

Study flow diagram

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 3

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.1

Comparison 1 Probiotics versus placebo in adults and children, Outcome 1 Symptomatic bacterial UTI.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.2

Comparison 1 Probiotics versus placebo in adults and children, Outcome 2 Worst case scenario ‐ symptomatic bacterial UTI.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.1

Comparison 2 Probiotics versus antibiotics in women, Outcome 1 Symptomatic bacterial UTI.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.2

Comparison 2 Probiotics versus antibiotics in women, Outcome 2 Worst case scenario probiotics ‐ symptomatic bacterial UTI.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.3

Comparison 2 Probiotics versus antibiotics in women, Outcome 3 Worst case scenario antibiotics ‐ symptomatic bacterial UTI.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.1

Comparison 3 Probiotics versus control in children with vesicoureteric reflux, Outcome 1 Symptomatic bacterial UTI.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.1

Comparison 4 Worst case scenario imputation ‐ symptomatic bacterial UTI, Outcome 1 Placebo comparison.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.2

Comparison 4 Worst case scenario imputation ‐ symptomatic bacterial UTI, Outcome 2 Antibiotic comparison ‐ worst case probiotics.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.3

Comparison 4 Worst case scenario imputation ‐ symptomatic bacterial UTI, Outcome 3 Antibiotic comparison ‐ worst case antibiotics.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Probiotics compared with placebo or antibiotics for urinary tract infections (UTI)
Patient or population: adults and children at risk of UTI Settings: outpatient Intervention: probiotics Comparison: placebo or antibiotics
Outcomes	*Illustrative comparative risks (95% CI)**		Relative effect (95% CI)	No of participants (studies)	Quality of the evidence (GRADE)	Comments
	Assumed risk	Corresponding risk
	Control	Probiotics
Symptomatic bacterial UTI in adults and children in patients with and without recurrent UTI Probiotics versus placebo (follow‐up)	395 per 1000	296 per 1000 (197 to 446)	RR 0.75 (0.50, 1.13)	352 (6)	⊕⊕⊝⊝ low	Risk of bias was assessed at unclear or high in most domains and suggest that results are imprecise or overestimate probiotic effects versus placebo
Symptomatic bacterial UTI in adults and children with recurrent UTI Probiotics versus placebo (follow‐up)	421 per 1000	315 per 1000 (227 to 425)	RR 0.74 (0.54, 1.01)	275 (4)	⊕⊕⊝⊝ low	Risk of bias was assessed at unclear or high in most domains and suggest that results are imprecise or overestimate probiotic effects versus placebo
Symptomatic bacterial UTI in women with recent UTI Probiotics versus antibiotics (follow‐up)	666 per 1000	745 per 1000 (632 to 885)	RR 1.12 (0.95, 1.33)	223 (1)	⊕⊕⊝⊝ low	Risk of bias was assessed at unclear or high in most domains and suggest that results are imprecise or overestimate probiotic effects versus antibiotics. Imprecision also due to small sample from only one RCT
Symptomatic bacterial UTI in children with VUR Probiotics versus placebo (follow‐up)	270 per 1000	145 per 1000 (64 to 332)	RR 0.54 (0.24, 1.23)	96 (1)	⊕⊕⊝⊝ low	Risk of bias was assessed at unclear or high in most domains of and suggest that results are imprecise or overestimate probiotic effects versus placebo. Imprecision also due to small sample from only one RCT
The basis for the assumed risk* (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk Ratio
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.
UTi ‐ urinary tract infection

Ir a la tabla de la revisión

Comparison 1. Probiotics versus placebo in adults and children

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Symptomatic bacterial UTI Show forest plot	6	352	Risk Ratio (M‐H, Random, 95% CI)	0.82 [0.60, 1.12]

1.1 Versus placebo	2	77	Risk Ratio (M‐H, Random, 95% CI)	1.12 [0.65, 1.93]
1.2 Versus placebo with recurrent UTI	4	275	Risk Ratio (M‐H, Random, 95% CI)	0.74 [0.52, 1.05]
2 Worst case scenario ‐ symptomatic bacterial UTI Show forest plot	6	352	Risk Ratio (M‐H, Random, 95% CI)	0.94 [0.63, 1.39]

2.1 Versus placebo	2	77	Risk Ratio (M‐H, Random, 95% CI)	3.71 [0.12, 112.47]
2.2 Versus placebo with recurrent UTI	4	275	Risk Ratio (M‐H, Random, 95% CI)	0.85 [0.60, 1.19]

Comparison 1. Probiotics versus placebo in adults and children

Ir a la tabla de la revisión

Comparison 2. Probiotics versus antibiotics in women

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Symptomatic bacterial UTI Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

1.1 Versus antibiotics with recent UTI	1		Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2 Worst case scenario probiotics ‐ symptomatic bacterial UTI Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

2.1 Versus antibiotics with recent UTI	1		Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3 Worst case scenario antibiotics ‐ symptomatic bacterial UTI Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

3.1 Versus antibiotics with recent UTI	1		Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

Comparison 2. Probiotics versus antibiotics in women

Ir a la tabla de la revisión

Comparison 3. Probiotics versus control in children with vesicoureteric reflux

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Symptomatic bacterial UTI Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

Comparison 3. Probiotics versus control in children with vesicoureteric reflux

Ir a la tabla de la revisión

Comparison 4. Worst case scenario imputation ‐ symptomatic bacterial UTI

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Placebo comparison Show forest plot	6	352	Risk Ratio (M‐H, Random, 95% CI)	0.94 [0.63, 1.39]

1.1 Versus placebo	2	77	Risk Ratio (M‐H, Random, 95% CI)	3.71 [0.12, 112.47]
1.2 Versus placebo with recurrent UTI	4	275	Risk Ratio (M‐H, Random, 95% CI)	0.85 [0.60, 1.19]
2 Antibiotic comparison ‐ worst case probiotics Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

2.1 Versus antibiotics with recent UTI	1		Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3 Antibiotic comparison ‐ worst case antibiotics Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

3.1 Versus antibiotics with recent UTI	1		Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

Comparison 4. Worst case scenario imputation ‐ symptomatic bacterial UTI

Ir a la tabla de la revisión

The Cochrane Library

Scolaris Language Selector Scolaris Language Selector

Idioma de la Revisión Cochrane

Idioma de la web

Scolaris Content Language Banner Portlet Scolaris Content Language Banner Portlet