OB/GYN article

Summary of Article: A systematic review of non-antibiotic measures for the prevention of urinary tract infections in pregnancy

 

The reasoning for conducting the study

UTI is very common among pregnant patient and even asymptomatic bacteria need to be treated to avoid further complications. This treatment process of UTI leads a lot of antibiotic prescription which leads to increase antibiotic resistance. The author of this article is trying to identify other non-pharmacological intervention that can be utilized to prevent frequent UTI.

 

Aim of the study:

The aim of this study was to systematically review the literature to identify and evaluate potential measures to prevent UTIs in pregnant women.

 

Methods

This systemic review looks at 10 well known databases (EMBASE, AMED, BNI, CINAHL, Medline, PubMed, PsycINFO, Cochrane Trials, Scopus and Science Direct) and identified 3276 articles that has the mesh terms of (“urinary tract infection” or UTI or bacteriuria or cystitis) AND (prevention) AND (pregnan*).

 

Inclusion Criteria:  five different measures: hygiene behavior, cranberry juice, immunization, ascorbic acid and canephron. These measures are most often recommended to prevent UTIs in pregnant patient.

 

Exclusion Criteria: duplicates, titles reviews

 

Based on the exclusion and inclusion criteria, out of 3276 articles, only 8 articles were selected that analyzed the effect of the five different measures in preventing UTI.

Significant Result:

Hygiene Behaviors

Based on this article hygiene behaviors are associated with decrease incidence of UTIs. The article analyzed hygiene behaviors such as direction of wash genitals, Number of bathing and changing underwear a weak, and sexual intercourses.

• Washing genitals from back to front is more likely to lead to UTI so providers can suggest patient to practice front to back wash methods as a way to prevent recurrent UTIs
• Sexual intercourse lead to higher probability of transfer of uropathogens into urethra so leading to higher incidence of UTI. So, providers can recommend patient to urinate and wash after themselves after sexual intercourse to prevent recurrent UTI.
• Also changing undergarments frequently leads to lower UTI so that could also be another part of advice to the patient.

 

Important Finding:

 Only hygiene behaviors have a significant effect on preventing UTI so based on evidence out of the five measures only hygiene behaviors is robust enough to be recommended in practice. Farther studies need to be conducted to effetely recommend the other measures such as cranberry juice , immunisation, ascorbic acid and Canephron.

 

Limitations of the studies

• Only English language publications were included therefore there might be options which have not been identified.
• The results of this review have been discussed using a narrative synthesis

 

ob:gyn article