Intravesical antibiotics (IVA) have been utilized in the prevention and treatment of recurrent urinary tract infections (rUTIs). There was, however, a lack of detailed data and agreement on its use. For a study, researchers undertook a systematic review to collect all available data on the efficacy of IVA in the prevention and treatment of rUTIs and to provide an overview of the results thus far. A systematic review was conducted for all English-language articles published from inception to August 2017 using MEDLINE, Scopus, Biomed Central, EMBASE, CINAHL, and Web of Science, with references, cross-checked and individual urology journals hand-searched, in accordance with the Cochrane and PRISMA standards. After identifying 658 research, the researchers examined 37 abstracts and 18 full-text publications, with 11 making the final cut. There were 285 patients in all, with an average age of 52 and a female: male ratio of 129:117. Gentamicin, neomycin/polymyxin, neomycin, or colistin were the IVAs utilized, and IVA was used as prevention in 5 trials (n=168) and therapy in 6 studies (n=117) for rUTIs. Overall, 78% saw a significant reduction in symptomatic UTI, with short-term success and discontinuation rates of 71% (120/168) and 8% (14/168) in the prophylactic group, and 88% (103/117) and 5% (6/117) in the treatment groups, respectively. The sensitivity of organisms changed in 30% (50/168) and 23% (27/117) of the treatment and prophylactic groups, respectively. Twenty patients terminated IVA installations, which was greater in the non-gentamicin group (11%) than in the gentamicin group (5% ). Allergy, suprapubic pain, autonomic dysreflexia, urinary tract infections, and diarrhea were among the mild adverse effects.
The intravesical antibiotic installation appeared to be a generally safe and successful technique of preventing and treating recurring UTIs, particularly in the short term. It provided doctors with an additional therapy option in high-risk patients who are susceptible to UTIs after all other systemic therapies have failed.
Reference:link.springer.com/article/10.1007/s11934-018-0834-8
