Pharmacist prescribers Linda Bryant and Leanne Te Karu discuss positive polypharmacy for heart failure. Current evidence shows the intensive implementation of four medications offers the greatest benefit to most patients with heart failure, with significant reductions in cardiovascular mortality, heart failure hospitalisations and all-cause mortality
Weigh up all options for prevention of recurrent urinary tract infections
Weigh up all options for prevention of recurrent urinary tract infections
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Pharmacist prescriber Linda Bryant discusses the prophylactic treatment options available to a young woman with recurrent urinary tract infections, including over-the-counter products, antibiotics, an antiseptic and more
1. Gbinigie O. Trimethoprim is associated with a greater risk of acute kidney injury and hyperkalaemia in older adults compared with other antibiotics used to treat UTIs. BMJ Evid Based Med 2018;23(6):233–34.
2. Botros C, Lozo S, Iyer S, et al. Methenamine hippurate compared with trimethoprim for the prevention of recurrent urinary tract infections: a randomized clinical trial. Int Urogynecol J 2022;33(3):571–80.
3. Bakhit M, Krzyzaniak N, Hilder J, et al. Use of methenamine hippurate to prevent urinary tract infections in community adult women: a systematic review and meta-analysis. Br J Gen Pract 2021;71(708):e528–37.
4. Harding C, Mossop H, Homer T, et al. Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women: multicentre, open label, randomised, non-inferiority trial. BMJ 2022;376:e068229.
5. Ferrante KL, Wasenda EJ, Jung CE, et al. Vaginal estrogen for the prevention of recurrent urinary tract infection in postmenopausal women: A randomized clinical trial. Female Pelvic Med Reconstr Surg 2021;27(2):112–17.
6. National Institute for Health and Care Excellence. Urinary tract infection (recurrent): antimicrobial prescribing. 31 October 2018. https://www.nice.org.uk/guidance/ng112
7. Nickel JC, Saz-Leal P, Doiron RC. Could sublingual vaccination be a viable option for the prevention of recurrent urinary tract infection in Canada? A systematic review of the current literature and plans for the future. Can Urol Assoc J 2020;14(8):281–87.