Extended treatment-dose antibiotic therapy bests low-dose prophylaxis for recurrent uncomplicated UTIs in postmenopausal women: Study

The primary outcome was one or more symptomatic, culture-proven UTIs within 12 months. Multivariable logistic regression assessed differences in the primary outcome while controlling for potential confounders. Results: Among the 246 patients, women receiving extended treatment dose antibiotics (n=43) had a significantly lower risk of experiencing subsequent UTI within 1 year when compared to those receiving standard prophylactic dosing for ≥3-months(n=203) (rate 34.9% vs 59.6%; P<0.01).

This significant risk reduction was maintained in logistic regression analyses while controlling for potentially confounding variables (aOR 0.42; 95% CI 0.20,0.89). Women treated with a 1-month course of treatment-strength antibiotics had a significantly lower risk of subsequent UTI within 12 months compared to women receiving ≥3-months of prophylactic antibiotics. These retrospective data preliminarily suggest that extended treatment-strength antibiotic dosing may provide therapeutic benefit while reducing overall cumulative antibiotic dose and duration. This innovative approach warrants further evaluation in randomized trials.

Douglas Luchristt, Nazema Y. Siddiqui, Yasmeen Bruton, Anthony G. Visco, Extended treatment-dose antibiotic therapy versus low-dose prophylaxis for the management of recurrent uncomplicated urinary tract infections in peri- and postmenopausal women. Urology, 2024, ISSN 0090-4295, https://doi.org/10.1016/j.urology.2024.12.029.