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Role of vaccines for recurrent urinary tract infections: a systematic review

Role of vaccines for recurrent urinary tract infections: a systematic review
Role of vaccines for recurrent urinary tract infections: a systematic review

Context: recurrent urinary tract infections (rUTIs) can be a difficult condition to treat, and the role of vaccines is unclear. Objective: To systematically review the role of vaccines in the treatment of rUTIs, looking at efficacy, adverse events, and discontinuation from treatment. 

Evidence acquisition: we systematically reviewed the role of vaccines for rUTIs using the Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) methodologies for all English-language articles from inception of databases to July 2018. Data were collected for different vaccine types, short- (≤6 mo) and long-term (>6 mo) efficacy, and adverse effects with risk of bias assessment of included studies. 

Evidence synthesis: after initial identification of 1680 articles, 36 abstracts were screened, 25 full-text articles were assessed, and 17 (including 3228 patients; 1970 in the vaccine group and 1258 in the comparison group) were included. There were three studies in Uromune, nine in OM-89/UroVaxom, four in Solco-Urovac, and one in ExPEC4 V groups. Uromune, UroVaxom, and Solco-Urovac reported on the short-term follow-up, and the overall efficacy for vaccination demonstrated a significant odds ratio (OR) of 0.17 (95% confidence interval [CI] 0.06–0.50). Uromune, UroVaxom, and ExPEC4 V reported on the long-term follow-up, and the overall efficacy for vaccination demonstrated a significant OR of 0.20 (95% CI 0.07–0.59). The reported side effects were mild and varied from 0% to 13% across studies, and treatment withdrawal or exclusion due to adverse events was reported in 11 patients. 

Conclusions: vaccines seem to have a short-term role in the prevention of recurrent urinary tract infections with tolerable side effects. However, due to lack of uniformity of definitions and long-term follow-up, more work needs to be done with inclusion of other high-risk patient groups. Patient summary: In this study, we look at the role of vaccines for recurrent urinary tract infections. We found that they seem to have a short-term role in the prevention of recurrent urinary tract infections and might play an increasing role in the future. In this study, we look at the role of vaccines for recurrent urinary tract infections (UTIs). We found that they seem to have a short-term role in the prevention of recurrent UTIs and might play an increasing role in the future.

Prophylaxis, Recurrent UTI, Treatment, Urinary tract infection, UTI, Vaccine
Prattley, Sarah
fe166d46-f5d3-4d84-838f-10eee44f85d5
Geraghty, Robert
ef19149e-530f-4749-9740-0902fed96fe1
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Prattley, Sarah
fe166d46-f5d3-4d84-838f-10eee44f85d5
Geraghty, Robert
ef19149e-530f-4749-9740-0902fed96fe1
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9

Prattley, Sarah, Geraghty, Robert, Moore, Michael and Somani, Bhaskar K. (2019) Role of vaccines for recurrent urinary tract infections: a systematic review. European Urology Focus. (doi:10.1016/j.euf.2019.11.002).

Record type: Review

Abstract

Context: recurrent urinary tract infections (rUTIs) can be a difficult condition to treat, and the role of vaccines is unclear. Objective: To systematically review the role of vaccines in the treatment of rUTIs, looking at efficacy, adverse events, and discontinuation from treatment. 

Evidence acquisition: we systematically reviewed the role of vaccines for rUTIs using the Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) methodologies for all English-language articles from inception of databases to July 2018. Data were collected for different vaccine types, short- (≤6 mo) and long-term (>6 mo) efficacy, and adverse effects with risk of bias assessment of included studies. 

Evidence synthesis: after initial identification of 1680 articles, 36 abstracts were screened, 25 full-text articles were assessed, and 17 (including 3228 patients; 1970 in the vaccine group and 1258 in the comparison group) were included. There were three studies in Uromune, nine in OM-89/UroVaxom, four in Solco-Urovac, and one in ExPEC4 V groups. Uromune, UroVaxom, and Solco-Urovac reported on the short-term follow-up, and the overall efficacy for vaccination demonstrated a significant odds ratio (OR) of 0.17 (95% confidence interval [CI] 0.06–0.50). Uromune, UroVaxom, and ExPEC4 V reported on the long-term follow-up, and the overall efficacy for vaccination demonstrated a significant OR of 0.20 (95% CI 0.07–0.59). The reported side effects were mild and varied from 0% to 13% across studies, and treatment withdrawal or exclusion due to adverse events was reported in 11 patients. 

Conclusions: vaccines seem to have a short-term role in the prevention of recurrent urinary tract infections with tolerable side effects. However, due to lack of uniformity of definitions and long-term follow-up, more work needs to be done with inclusion of other high-risk patient groups. Patient summary: In this study, we look at the role of vaccines for recurrent urinary tract infections. We found that they seem to have a short-term role in the prevention of recurrent urinary tract infections and might play an increasing role in the future. In this study, we look at the role of vaccines for recurrent urinary tract infections (UTIs). We found that they seem to have a short-term role in the prevention of recurrent UTIs and might play an increasing role in the future.

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EUF_834 - vaccine - Accepted Manuscript
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More information

Accepted/In Press date: 3 November 2019
e-pub ahead of print date: 2 December 2019
Keywords: Prophylaxis, Recurrent UTI, Treatment, Urinary tract infection, UTI, Vaccine

Identifiers

Local EPrints ID: 437419
URI: http://eprints.soton.ac.uk/id/eprint/437419
PURE UUID: 0531da69-6300-48c3-a48c-b190c426cde3
ORCID for Michael Moore: ORCID iD orcid.org/0000-0002-5127-4509

Catalogue record

Date deposited: 29 Jan 2020 17:36
Last modified: 17 Mar 2024 05:15

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Contributors

Author: Sarah Prattley
Author: Robert Geraghty
Author: Michael Moore ORCID iD

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