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Recurrent urinary tract infections (RUTI) are common in women generally, and particularly in pregnant women. A urinary tract infection (UTI) is an infection of the urinary tract (bladder, kidneys) due to the presence of bacteria in the urine (bacteriuria). During pregnancy, UTI may be a serious complication that is associated with adverse pregnancy outcomes for both mother and child including preterm birth and small‐for‐gestational‐age babies. Therefore, it is important to define the optimal intervention for preventing RUTI during pregnancy to improve pregnancy outcomes. Interventions used to prevent RUTI in pregnant women can be pharmacological (antibiotics) or non‐pharmacological (cranberry products, acupuncture, probiotics and behavioural modifications). So far, little is known about the best way to prevent RUTI in pregnant women.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 26, 2015

Bladder and kidney infections (urinary tract infection ‐ UTI) are common in children, especially girls. They cause an uncomfortable illness that can include vomiting, fever and tiredness. In some children kidney damage may occur, as can repeat illnesses. With repeated infections the risk of kidney damage increases. Some doctors prescribe long‐term antibiotics to try to prevent infections recurring, but this may cause the child to be unwell in other ways, e.g. vomiting. This review of randomised controlled trials (RCTs) found evidence that long‐term antibiotics did reduce the risk of more symptomatic infections but the benefit is small and must be weighed against the likelihood that future infections may be with bacteria that are resistant to the antibiotic given.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: March 16, 2011

In the past 30–50 years, the natural history of urinary tract infection (UTI) in children has changed as a result of the introduction of antibiotics and improvements in health care. This change has contributed to uncertainty about the most appropriate and effective way to diagnose and treat UTI in children and whether or not investigations and follow-up are justified.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: August 2007

Acute uncomplicated lower urinary tract infection (UTI), also know as cystitis, is characterised by burning on urination and frequent urination without fever or flank pain. It is a common event in otherwise healthy, non‐pregnant adult women. A large range of antimicrobials are used in the treatment of cystitis. Twenty one good quality studies, enrolling 6016 participants, which used different classes of antimicrobials for treating acute cystitis in women for 3 up to 10 days, were included in this review. The classes of antimicrobials included in the review proved equally effective for the symptomatic cure. Fluoroquinolones proved more effective than beta‐lactams for the short‐term bacteriological cure, but the significance of this finding is doubtful. Fewer rashes developed in patients treated with fluoroquinolones. Nitrofurantoin caused fewer rashes than TMP‐SMX while having similar rates of any adverse events. Given the small number of studies included in each comparison and for each outcome it is recommended that further randomised controlled trials be conducted.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: October 6, 2010

Between 5% and 10% of pregnant women have bacteria in their urine without symptoms of infection (asymptomatic bacteriuria). If left untreated, women may go on to develop serious complications such as kidney infection or preterm birth. In this review we looked at studies comparing different antibiotic treatments for asymptomatic bacteriuria to see which antibiotics or which course of the same antibiotics (shorter versus longer courses) were most effective for reducing infection. We also looked at side effects such as vomiting. The studies included in this review failed to demonstrate any newer antibiotic or regimen which would be better than the older antibiotics and the traditional regimen.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: September 8, 2010

CADTH undertook a study into antibiotic prescribing and use in Canadian primary care practice, with a particular emphasis on fluoroquinolone use. The study investigated current practices and implementation issues for antibiotic therapies from the perspective of family physicians (FPs), nurse practitioners (NPs), and pharmacists. The research findings are based on the results of qualitative research in the form of surveys of primary care practitioners, as well as on a targeted review of the literature on fluoroquinolones use in Canada. CADTH sought to understand and explain experiences and decision-making processes around outpatient prescribing of antibiotics for specific indications. This report presents a summary of the findings.

CADTH Technology Review - Canadian Agency for Drugs and Technologies in Health.

Version: May 2017

The guideline covers adults and children (from birth) with lower urinary tract dysfunction resulting from neurological disease or injury.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: August 2012

It is difficult to know what the true incidence of metastatic spinal cord compression (MSCC) is in England and Wales because the cases are not systematically recorded. However, evidence from an audit carried out in Scotland between 1997 and 1999 and from a published study from Ontario, Canada, suggests that the incidence may be up to 80 cases per million population per year. This would mean around 4000 cases per year in England and Wales or more than 100 cases per cancer network per year.

NICE Clinical Guidelines - National Collaborating Centre for Cancer (UK).

Version: November 2008

Since the publication of the NICE clinical guideline on the prevention of healthcare-associated infections (HCAI) in primary and community care in 2003, many changes have occurred within the NHS that place the patient firmly at the centre of all activities. First, the NHS Constitution for England defines the rights and pledges that every patient can expect regarding their care. To support this, the Care Quality Commission (CQC), the independent regulator of all health and adult social care in England, ensures that health and social care is safe, and monitors how providers comply with established standards. In addition, the legal framework that underpins the guidance has changed since 2003.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: March 2012

It is estimated that in 2009, more than 3 million kilograms of antimicrobials were administered to human patients in the United States. While the life-saving benefits of antimicrobials are indisputable, the consequences of use and misuse must also be considered. Major concerns related to the use of antimicrobials are increasing resistance, higher incidence of Clostridium difficile (C. difficile) infection (CDI) and increased healthcare costs (including costs related to adverse events associated with antimicrobial use).

Evidence-based Synthesis Program - Department of Veterans Affairs (US).

Version: September 2013

This clinical guideline was commissioned by NICE and developed by the National Collaborating Centre for Mental Health. It sets out clear, evidenceand consensus-based recommendations for healthcare staff on how to treat and manage depression in adults with a chronic physical health problem.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2010

We compared the effectiveness and harms of anticonvulsants, tricyclic antidepressants, serotonin–norepinephrine reuptake inhibitors (SNRIs), and the lidocaine patchin adults with neuropathic pain.

Drug Class Reviews - Oregon Health & Science University.

Version: June 2011

The majority of antimicrobials prescribed to humans originate in outpatient settings. In making prescribing decisions, primary care providers are faced with patient expectations, and with patient and provider lack of awareness of antimicrobial resistance and lack of understanding of the seriousness of the antimicrobial resistance problem.

Evidence-based Synthesis Program - Department of Veterans Affairs (US).

Version: February 2014

Expert-reviewed information summary about constipation, impaction, bowel obstruction, and diarrhea as complications of cancer or its treatment. The management of these problems is discussed.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: May 9, 2018

Non–muscle-invasive bladder cancer (NMIBC) frequently recurs and can progress to muscle-invasive disease. This report reviews the current evidence on emerging approaches to diagnosing and treating bladder cancer.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: October 2015

Unnecessary prescribing of antibiotics is a major problem in the US and worldwide, contributing to the problem of antimicrobial resistance (AMR). This review examines the effects of quality improvement strategies on reducing inappropriate prescribing of antibiotics, targeting both prescribing of antibiotics for non-bacterial illnesses (“the antibiotic treatment decision”) and prescribing of broad-spectrum antibiotics when narrow-spectrum agents are indicated (“the antibiotic selection decision”).

Technical Reviews - Agency for Healthcare Research and Quality (US).

Version: January 2006

The original antenatal care guideline was published by NICE in 2003. Since then a number of important pieces of evidence have become available, particularly concerning gestational diabetes, haemoglobinopathy and ultrasound, so that the update was initiated. This update has also provided an opportunity to look at a number of aspects of antenatal care: the development of a method to assess women for whom additional care is necessary (the ‘antenatal assessment tool’), information giving to women, lifestyle (vitamin D supplementation, alcohol consumption), screening for the baby (use of ultrasound for gestational age assessment and screening for fetal abnormalities, methods for determining normal fetal growth, placenta praevia), and screening for the mother (haemoglobinopathy screening, gestational diabetes, pre-eclampsia and preterm labour, chlamydia).

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: March 2008

Proton pump inhibitors decrease secretion of gastric acid. They act by blocking the last enzyme in the system that actively transports acid from gastric parietal cells into the gastrointestinal lumen, hydrogen–potassium adenosine triphosphatase, also known as the proton pump. Omeprazole, the first drug in this class, was introduced in 1989. Since then, 4 other proton pump inhibitors have been introduced: lansoprazole (1995), rabeprazole (1999), pantoprazole (2000), and esomeprazole (2001). In 2003 omeprazole became available over-the-counter in the United States. The purpose of this review is to compare the benefits and harms of different PPIs.

Drug Class Reviews - Oregon Health & Science University.

Version: May 2009

OBJECTIVE: To determine whether antibiotic prophylaxis can reduce the risk of postoperative infective complications in patients undergoing percutaneous nephrolithotomy (PCNL) who have sterile preoperative urine.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

This review assessed furazolidone-based and nitrofurantoin-based regimens for the eradication of Helicobacter pylori infection and concluded that furazolidone-based primary triple therapies were less efficient than standard therapies. Furazolidone-based primary quadruple therapies were more efficient than furazolidone-based primary triple therapies. Given uncertainty over parts of the review process and study quality, the findings should be interpreted with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

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