A systematic review of the outcomes reported in the treatment of uncomplicated urinary tract infection clinical trials

Background
Uncomplicated urinary tract infections (UTIs) are amongst the most frequent infections presenting in the outpatient setting. A growing number of clinical trials are assessing the most effective treatment interventions for uncomplicated UTI. Due to the heterogeneity of the outcomes reported in these trials, however, comparing these outcomes is challenging.

Objectives
Identify the core outcomes that have been reported in trials and systematic reviews of interventions treating uncomplicated UTI in adults.

Methods
We conducted a systematic search for core outcomes used to evaluate treatments of UTIs. We searched the Cochrane Database of Systematic Reviews, PubMed and Embase. One researcher independently screened each article for inclusion, and the Core Outcome Set for treatment of Urinary Tract Infections (COSUTI) team acted as second reviewers. All included articles were screened by two reviewers. All outcomes were extracted verbatim, and similar outcomes were grouped into domains and subdomains.

Results
In total, 334 outcomes were reported across 41 papers, the average number of outcomes reported being 8. Outcomes were categorized across 18 domains, the majority of which were related to clinical cure outcomes. Many outcomes varied in the timepoints within which the outcome was measured and reported.

Conclusions
Comparing the outcomes of trials investigating uncomplicated UTI treatment remains challenging due to the difference in outcomes currently reported. Consistency of reporting of outcomes would be improved by developing a minimum number of consistent outcomes that should be reported in all trials.

Aim

Identify the core outcomes that have been reported in trials and systematic reviews of interventions treating uncomplicated UTI in adults.

Contributors

Sinead Duane, Claire Beecher, Akke Vellinga, Andrew W. Murphy, Martin Cormican, Andrew Smyth, Patricia Healy, Michael Moore, Paul Little, and Declan Devane.

Publication

Journal: JAC Antimicrob Resistance
Volume: 4
Issue: 2
Pages: dlac025 -
Year: 2022
DOI: 10.1093/jacamr/dlac025

Further Study Information

Current Stage: Completed
Date:
Funding source(s): This research was funded by the HRB Primary Care Clinical Trials Network (grant reference number CTN-2014-011).


Health Area

Disease Category: Urology

Disease Name: Urinary Tract Infection

Target Population

Age Range: Unknown

Sex: Either

Nature of Intervention: Behavioural , Drug, Surgery

Stakeholders Involved

Study Type

- Systematic review of outcomes measured in trials

Method(s)

- Systematic review

Included in this review were all randomized trials and systematic reviews of randomized trials (with and without meta-analyses) comparing the effectiveness of any interventions for the treatment of uncomplicated UTI or cystitis in healthy adults. Recurrent UTIs and pyelonephritis were excluded as they were beyond the scope of this study. A combination
of search terms was used to search for relevant studies between 2007 and 2017 within the Cochrane Database of Systematic Reviews (including CENTRAL, CDSR and DARES), PubMed and Embase. Search terms included: urinary tract infection; UTI; Cystitis, Randomized controlled trial; Controlled clinical trial; randomized; Placebo; randomly; trial