Recurrent recurrent rates while proving an efficacy

Recurrent uncomplicated urinary
tract infection (UTI) is one of the commonest presentations to Urologists which
causing morbidity and the main reason for antibiotic prescribing. 1 Approximately, 25% of patients who were diagnosed with acute
cystitis with UTI will develop a recurrence episode.2 These infections are a leading source for morbidity and Risk
factors vary from patient to another depends on predominant 3such as sexual intercourse, spermicide-based contraception, history
of previous UTIs even a genetic mutation play
a major role in these patients 1,4.

Recurrent UTI is a major medical
disorder that’s caused by Bacterial disease such as Escherichia coli which
plays a predominant pathogen which affects young women5

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However, RUTI refers to three or
more episodes of uncomplicated symptomatic UTI or cystitis per year including
symptoms of dysuria, frequency or nocturia which may follow a complete clinical
resolution of a previous UTI with absence of obstruction, resistant pathogen or
any tract abnormalities6

It can be caused by another organism
such as Staphylococcus saprophyticus, Enterococcus, Klebsiella, Enterobacter,
or Proteus that may leads to Cystitis or an upper tract infection.7

RUTI can be diagnosed as a clinical
picture even with absence of structural or functional abnormalities while Guidelines
prefer Culture as the best method for diagnosing UTI.1


Many of Antimicrobial Prophylaxis
such as Trimethoprim, Nitrofurantoin, Cephalexin, Ciprofloxacin, Norfloxacin,
Ofloxacin, Fosfomycin and others shows a significance reduction of recurrent
rates while proving an efficacy of reducing the risk of Recurrent UTIs that Occurs
in healthy patients with uncomplicated cases in a several trials. 8-11
As a follow up, Urologists recommend for their patients a longer courses as long
term for antibiotics in patients who continue to have recurrent symptomatic

On the other hand, Previous Study
didn’t show a reduction of recurrence rates of UTI episodes with severe adverse
events such as gastrointestinal, skin rash and severe nausea with treatment
withdrawal that seems a point of controversy with other studies 6

For that, there is no clear evidence
to guide treatment specially for the long-term effect of Using antibiotics as
prophylaxis. In this vein, we designed this study in attempt to resolve this

Our aim from this Study is to
systematically review and conduct a meta-analysis of randomized controlled
trials which assess the efficacy of antibiotics prophylaxis as long term for
female patients with Recurrent Urinary tract infection and to evaluate the
safety during the follow up after 1-year duration.