Urinary alkalisation for uncomplicated urinary tract infections

Urinary tract infection (UTI) is the most common form of bacterial infection among women and can cause pain and frequent urination.

Urinary alkalisers are medications that reduce the acidity of urine; these are commonly purchased over the counter, or prescribed by doctors to treat the symptoms of UTI.

We aimed to investigate the benefits and harms of urinary alkalisers for the treatment of UTI. We searched the literature to 19 January 2016 but found no randomised controlled trials (RCTs) undertaken to investigate these agents that met our study inclusion criteria. We were unable to judge the benefits or harms of the use urinary alkalisers in the context of UTI.

It is important that further research in the form of RCTs be carried out to determine the benefits or harms of urinary alkalisers.

Authors' conclusions: 

Until relevant evidence is generated from randomised trials, the safety and efficacy of urinary alkalisers for the symptomatic treatment of uncomplicated UTI remains unknown.

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Background: 

Uncomplicated urinary tract infection (UTI) is the most common bacterial infection in women, characterised by dysuria and urinary frequency. Urinary alkalisers are widely used in some countries for the symptomatic treatment of uncomplicated UTI, and they are recommended in some national formularies. However, there is a lack of empirical evidence to support their use for UTI and some healthcare guidelines advise against their use.

Objectives: 

We aimed to look at the benefits and harms of the use of urinary alkalisers for the treatment of uncomplicated UTIs in adult women.

Search strategy: 

We searched the Cochrane Kidney and Transplant Specialised Register to 19 January 2016 through contact with the Trials Search Co-ordinator using search terms relevant to this review.

Selection criteria: 

All randomised controlled trials (RCTs) and quasi-RCTs on the use of (any) urinary alkalisers (either exclusively or non-exclusively) for the symptomatic treatment of uncomplicated UTI amongst women aged 16 and over, were included. Studies were eligible if they included patients whose diagnosis of UTI was decided by symptoms alone, or positive urine dipstick test or urine culture; and patients with recurrent UTI, provided patients had no symptoms of UTI in the two weeks prior to the onset of symptoms that lead them to seek medical advice. Studies were ineligible if they studied patients with complicated UTIs; immune-compromising conditions; acute pyelonephritis; or chronic conditions such as interstitial cystitis.

Data collection and analysis: 

Three authors independently assessed and screened papers, and this was repeated by two separate authors (independently). An additional investigator acted as arbitrator, where necessary. There were no papers which fulfilled the inclusion criteria for this review, and therefore no data extraction was performed.

Main results: 

Our search identified 172 potential studies for inclusion. However, following assessment none fulfilled the inclusion criteria for this review.

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