ArticleBJGP open2017
Cost-effectiveness of antibiotic treatment of uncomplicated urinary tract infection in women: a comparison of four antibiotics.
Article in BJGP open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Point-of-care tests for urinary tract infections to reduce antimicrobial resistance: a systematic review and conceptual economic model.Health technology assessment (Winchester, England) · 2024Pooled it
- Antibiotics efficacy in clinical and microbiological cure of uncomplicated urinary tract infection: a systematic review and network meta-analysis.World journal of urology · 2024Pooled it
- The sublingual vaccine MV140 is dominant over prophylactic antibiotics for the prevention of recurrent, uncomplicated urinary tract infections in adult women A cost-utility analysis.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2026Article
- Rapid antibiotic susceptibility testing for urinary tract infections in secondary care in England: a cost-effectiveness analysis.BMJ open · 2024Article
- Article
- Water intake and recurrent urinary tract infections prevention: economic impact analysis in seven countries.BMC health services research · 2023Article
- Real-Life Comparison of Fosfomycin to Nitrofurantoin for the Treatment of Uncomplicated Lower Urinary Tract Infection in Women.Biomedicines · 2023Article
- Unmet Needs in Complicated Urinary Tract Infections: Challenges, Recommendations, and Emerging Treatment Pathways.Infection and drug resistance · 2023Review
- Cost-Effectiveness of a Sublingual Bacterial Vaccine for the Prophylaxis of Recurrent Urinary Tract Infections.Urologia internationalis · 2022Article
- A Cost-Effectiveness Analysis of Fosfomycin: A Single-Dose Antibiotic Therapy for Treatment of Uncomplicated Urinary Tract Infection.Health services insights · 2022Article
- Fosfomycin and nitrofurantoin: classic antibiotics and perspectives.The Journal of antibiotics · 2021Review
- Clinical Efficacy and Cost Analysis of Antibiotics for Treatment of Uncomplicated Urinary Tract Infections in the Emergency Department of a Tertiary Hospital in Saudi Arabia.Therapeutics and clinical risk management · 2021Article
- Efficacy and Safety of Single-dose Fosfomycin for Uncomplicated Urinary Tract Infection in Women: Systematic Review and Meta-analysis.Journal of mid-life healthReview
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUrinary tract infections (UTIs) are one of the most common reasons for women to attend primary care. There are four different antibiotics currently recommended in England for treatment of uncomplicated UTI but little evidence on their comparative cost-effectiveness.
aimTo assess the relative cost-effectiveness of the four antibiotics currently recommended in England for treatment of uncomplicated UTI in adult women. DESIGN &
settingA cost-effectiveness model in adult women with signs and symptoms of uncomplicated UTI in primary care in England treated with fosfomycin, nitrofurantoin, pivmecillinam, or trimethoprim.
methodA decision tree economic model of the treatment pathway encompassed up to two rounds of treatment, accounting for different resistance levels. End points included recovery, persistence, pyelonephritis, and/or hospitalisation. Prescription, primary and secondary care treatment, and diagnostic testing costs were aggregated. Cost-effectiveness was assessed as cost per UTI resolved.
resultsTrimethoprim 200 mg twice daily (for 3 or 7 days) was estimated to be the most cost-effective treatment (£70 per UTI resolved) when resistance was <30%. However, if resistance to trimethoprim was ≥30%, fosfomycin 3 g once became more cost-effective; at resistance levels of ≥35% for trimethoprim, both fosfomycin 3 g once and nitrofurantoin 100 mg twice daily for 7 days were shown to be more cost-effective.
conclusionKnowing local resistance levels is key to effective and cost-effective empirical prescribing. Recent estimates of trimethoprim resistance rates are close to 50%, in which case a single 3 g dose of fosfomycin is likely to be the most cost-effective treatment option.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.