UTI is a common medical problem seen in family medicine. Unfortunately, some patients have more than one episode in a year. In this systemic review, and meta-analysis the authors evaluated patients 12 years and older who had a two or more UTI within 6 months or three within a year. The researchers searched Cochrane, RCT, Medline, and EMBASE. The purpose of this study is whether prophylactic antibiotics are beneficial to patients who get frequent UTI. 

The authors found that: In the 11 placebo-controlled trials, the risk for developing UTI was 85% lower with prophylaxis in comparison with placebo.

In antibiotics to antibiotic comparison Nitrofurantoin was the single most common comparator the pooled relative risk between nitrofurantoin and other comparator antibiotics indicated no significant difference. The authors found no difference between norfloxacin, Bactrim, and Nitrofurantoin in terms of efficacy in treating UTI.

In the authors analysis of 23 studies, it found that antibiotic prophylaxis is effective in treating recurrent UTI prevention when compared to placebo. However, the optimal dosage and duration of antibiotics remain unclear. Additionally, long-term antibiotics are associated with side-effects and high rates of resistance. The clinical bottom line is that even though giving antibiotic prophylaxis to treat recurrent UTI is effective, the side-effects outweigh the benefits.  The authors did the allude that activities that precipitate UTI such as sexual intercourse could be a reason to provide prophylaxis antibiotics.