| Insufficient evidence to demonstrate effectiveness of cephalexin versus other antibiotics. |
Citation/s:
- Vazquez JC, Villar J. Treatments for symptomatic rinary tract infections during pregnancy. Cochrane Database of Systemic Reviews 2003, Issue 4.
- Wing DA, Colleen M, Hendershott MD, Deblique L RN, Millar LK MD. A Randomized Trial of Three Antibiotic Regimens for the Treatment of Pyelonephritis in Pregnancy. Obstetrics and Gynaecology 1998; 92249-253
Lead author's name and fax: Vacquez JC
Three-part Clinical Question: In pregnant women with urinary tract infection (UTI) is cephalexin effective for cure and to prevent recurrence.
Population: pregnant and UTI;
Intervention: cephalexin;
Comparison:other antibiotics; Outcome:cure/recurrence
Search Terms: NLH: urinary tract infection and pregnan*
The Review:
Data Sources: : Cochrane Library, Medline, hand search, non-English sources,
Study Selection: Randomised comparisons of antibiotic treatments/ regimes to treat symptomatic UTIs in pregnancy.
No information about selection of eligible studies by authors.
Data Extraction: Both review authors
independently extracted the data. Differences resolved by discussion.
The studies were multiple independent reviews of individual reports. They were tested for heterogeneity.
The Evidence:
| Outcome | Time to Outcome | Typical CER | Typical OR | RRR | NNT | p Value |
| Comparing IV cephazolin v IV ampicillin & gentamycin. Cure rate | 3 days | 0.934 | 1.26 | -1% | -78 | 0.8 |
|---|---|---|---|---|---|---|
| 95% Confidence Intervals: | 0.28 to 5.77 | 7 to -19 | ||||
| Comparing IV cephazolin v IV ampicillin & gentamycin. Incidence prolonged pyrexia | 3 days | 0.096 | 0.7 | 28% | 37 | 0.6 |
| 95% Confidence Intervals: | 0.19 to 2.53 | 13 to -9 | ||||
| Comparing IV cephazolin v IV ampicillin & gentamycin. neontal ICU | To delivery | 0.158 | 1.5 | -39% | -16 | 0.4 |
| 95% Confidence Intervals: | 0.57 to 3.95 | 16 to -4 | ||||
Comments:
The outcomes of the nine randomised controlled trials varied too much for the
authors to do a meta analysis and for the same reason it was not possible to do
an overall data analysis on this CAT. Therefore data from the most relevant RCT
was used for analysis and this highlighted the overall conclusion of all the RCT's
in the systemic review: there is insufficient evidence to recommend specific
antibiotic treatment regimes for UTI in pregnancy.
Further research on duration and dose of antibiotics for cure/prevention of recurrence is needed.
Appraised by: Jane Lucas, and Pallavi Latthe, Birmingham Women's Hospital.; 03 October 2006
Email: jane_lucas@talk21.com
Kill or Update By: October 2008
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