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Effect of pravastatin and fosinopril on recurrent urinary tract infections.
- Source :
-
The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2013 Mar; Vol. 68 (3), pp. 708-14. Date of Electronic Publication: 2012 Oct 30. - Publication Year :
- 2013
-
Abstract
- Objectives: Recurrent urinary tract infections (UTIs) are a problem affecting both women and men. Animal experiments and in vitro studies indicate that statins might prevent recurrent UTIs. We assessed the effects of pravastatin on UTI antibiotic prescribing among adults.<br />Methods: A post hoc analysis was conducted with data from PREVEND IT, a trial among participants randomized to receive pravastatin, fosinopril or placebo in a 2 × 2 factorial design over 4 years. Trial data were linked to the pharmacy prescription database IADB.nl. The primary outcome was the number of prescriptions with a nitrofuran derivate, a sulphonamide or trimethoprim as a proxy for UTI antibiotic prescribing. Generalized estimating equations were used to estimate the effect on the number of UTI antibiotic prescriptions. Cox regression was used to determine the effect on first and second (recurrent) UTI antibiotic prescriptions.<br />Results: Of the 864 trial participants, 655 were eligible for analysis. During an average follow-up of 3.8 years, 112 (17%) participants received at least one UTI antibiotic prescription. Intention-to-treat analyses showed that pravastatin was associated with a reduced total number of UTI antibiotic prescriptions (relative risk, 0.43; 95% CI, 0.21-0.88) and occurrence of second UTI antibiotic prescriptions [hazard ratio (HR), 0.25; 95% CI, 0.08-0.77]. No significant effect on occurrence of first UTI antibiotic prescriptions was found (HR, 0.83; 95% CI, 0.57-1.20). Fosinopril was associated with an increased occurrence of first UTI antibiotic prescriptions (HR, 1.82; 95% CI, 1.16-2.88). Combination therapy with fosinopril and pravastatin did not significantly influence the number of UTI antibiotic prescriptions.<br />Conclusions: This study suggests that pravastatin can reduce the occurrence of recurrent UTIs. Larger studies among patients with recurrent UTIs are warranted.
- Subjects :
- Adult
Aged
Animals
Female
Humans
Male
Middle Aged
Secondary Prevention
Anticholesteremic Agents administration & dosage
Antihypertensive Agents administration & dosage
Drug Prescriptions statistics & numerical data
Fosinopril administration & dosage
Nitrofurans therapeutic use
Pravastatin administration & dosage
Urinary Tract Infections prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1460-2091
- Volume :
- 68
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- The Journal of antimicrobial chemotherapy
- Publication Type :
- Academic Journal
- Accession number :
- 23111852
- Full Text :
- https://doi.org/10.1093/jac/dks419