Afshar Kambiz, et al.
BMC complementary and alternative medicine, 2018
Abstract
Background
Uncomplicated urinary tract infections (UTI) are common in general practice and usually treated with antibiotics. This contributes to increasing resistance rates of uropathogenic bacteria. A previous trial showed a reduction of antibiotic use in women with UTI by initial symptomatic treatment with ibuprofen. However, this treatment strategy is not suitable for all women equally. Arctostaphylos uva-ursi (UU, bearberry extract arbutin) is a potential alternative treatment. This study aims at investigating whether an initial treatment with UU in women with UTI can reduce antibiotic use without significantly increasing the symptom burden or rate of complications.
Methods
This is a double-blind, randomized, and controlled comparative effectiveness trial. Women between 18 and 75 years with suspected UTI and at least two of the symptoms dysuria, urgency, frequency or lower abdominal pain will be assessed for eligibility in general practice and enrolled into the trial. Participants will receive either a defined daily dose of 3 × 2 arbutin 105 mg for 5 days (intervention) or fosfomycin 3 g once (control). Antibiotic therapy will be provided in the intervention group only if needed, i.e. for women with worsening or persistent symptoms. Two co-primary outcomes are the number of all antibiotic courses regardless of the medical indication from day 0-28, and the symptom burden, defined as a weighted sum of the daily total symptom scores from day 0-7. The trial result is considered positive if superiority of initial treatment with UU is demonstrated with reference to the co-primary outcome number of antibiotic courses and non-inferiority of initial treatment with UU with reference to the co-primary outcome symptom burden.
Discussion
The trial's aim is to investigate whether initial treatment with UU is a safe and effective alternative treatment strategy in women with UTI. In that case, the results might change the existing treatment strategy in general practice by promoting delayed prescription of antibiotics and a reduction of antibiotic use in primary care.
Trial registration
EudraCT: 2016-000477-21 . Clinical trials.gov: NCT03151603 (registered: 10 May 2017).
Keywords
Antibiotic prescription; Arctostaphylos uva-ursi; Comparative effectiveness design; General practice; Herbal remedy.
Conflict of interest statement
Ethics approval and consent to participate
Ethical approval has been obtained by the Independent Ethics Committees of the University Medical Center Göttingen (No. 16/11/16). Informed written consent will be obtained from all participants prior to any trial-related procedures.Consent for publication
Not applicable.Competing interests
The authors have no conflicts of interest to declare. Haupt Pharma Wulfing GmbH was contracted to produce and repack the trial medication (Arctuvan®). The company did not have influence on the study design and will participate neither in the clinical project management nor in the collection, analysis, and interpretation of data.Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.| PMID: | 29970072 |
|---|---|
| DOI: | 10.1186/s12906-018-2266-x |
| PMCID (Free PMC Article): | PMC6029138 |
| Category: | Urinary Tract |
The best supplements with Arctostaphylos Uva Ursi in Urinary Tract category:
- Kidney Cleanse, 90 Veggie Caps (Now Foods) - A healthy urinary tract is essential for maintaining the body's normal fluid balance and for cleansing the body of metabolic wastes. It contains among others: Arctostaphylos Uva Ursi.
- Water Out, Fluid Balance, 100 Veggie Caps (Now Foods) - NOW Water Out is a blend of complementary herbs and nutrients formulated to support healthy urinary tract function and proper bodily fluid balance. It contains among others: Arctostaphylos Uva Ursi.
Articles similar to "Reducing Antibiotic Use for Uncomplicated Urinary Tract Infection in General Practice by Treatment With Uva-Ursi (REGATTA) - A Double-Blind, Randomized, Controlled Comparative Effectiveness Trial."
- The role of Arctostaphylos Uva Ursi in Urinary Tract: Uva-ursi Extract and Ibuprofen as Alternative Treatments for Uncomplicated Urinary Tract Infection in Women (ATAFUTI): A Factorial Randomized Trial. (Objectives: The aim was to investigate if offering symptomatic therapy (Uva-ursi or ibuprofen) alongside a delayed prescription would relieve symptoms and reduce the consumption of antibiotics for adult women presenting with acute uncomplicated urinary tract infection (UTI)... We found no evidence of an effect of either intervention on the severity of frequency symptoms. There is evidence that advice to take ibuprofen will reduce antibiotic consumption without increasing complications. For every seven women given this advice, one less will use antibiotics. )
- The impact of Arctostaphylos Uva Ursi on Urinary Tract: Risk Assessment of Free Hydroquinone Derived From Arctostaphylos Uva-ursi Folium Herbal Preparations. (Uva-ursi folium (bearberry leaf) has been traditionally used to treat symptoms of lower urinary tract infections... We found no evidence of an effect of either intervention on the severity of frequency symptoms. There is evidence that advice to take ibuprofen will reduce antibiotic consumption without increasing complications. For every seven women given this advice, one less will use antibiotics. )
- The significance of Arctostaphylos Uva Ursi for Urinary Tract: Botanical medicines for the urinary tract. (Four important categories of urologic herbs, their history, and modern scientific investigations regarding them are reviewed... We found no evidence of an effect of either intervention on the severity of frequency symptoms. There is evidence that advice to take ibuprofen will reduce antibiotic consumption without increasing complications. For every seven women given this advice, one less will use antibiotics. )
Previous article
Antimutagenic and Antioxidant Activity of a Protein Fraction From Aerial Parts of Urtica Dioica.