Abstract
Objective: The goal of the present study was to evaluate treatment with Canephron® compared to standard antibiotic treatment after diagnosis of acute cystitis or urinary tract infection (UTI), with regard to the risk of sporadic recurrent UTIs, frequent recurrent UTIs, UTI-related sick leave, additional antibiotic prescriptions, and renal complications (pyelonephritis). Methods: This retrospective cohort study was based on data from the IMS® Disease Analyzer database (IQVIA), and included outpatients in Germany with at least one diagnosis of acute cystitis or UTI with a prescription of either Canephron® or standard antibiotics between January 2016 and June 2019 and treated in general practitioner (GP), gynecologist, or urologist practices, from which the data were obtained. Multivariable regression models were used to investigate the association between Canephron® prescription and the amount of sporadic or frequent recurrent UTIs, as well as the duration of UTI-related sick leave, the number of additional antibiotic prescriptions, and cases of pyelonephritis. The effects of Canephron® were adjusted for age, sex, insurance status, and Charlson comorbidity score (CCI). Results: 2320 Canephron® patients and 158,592 antibiotic patients were available for analysis. Compared to antibiotic prescription, Canephron® prescription was significantly associated with fewer sporadic recurrences of UTI infections 30–365 days after the index date (odds ratio (OR): 0.66; 95%, confidence interval (CI): 0.58–0.72), as well as less frequent recurrences of UTI infections (OR: 0.61; 95% CI: 0.49–0.88), and also with reduced additional antibiotic prescription within 31–365 days (OR: 0.57; 95% CI: 0.52–0.63). No significant differences were observed between the Canephron® and antibiotic cohorts with regard to the likelihood of sick leave (OR: 0.99; 95% CI: 0.86–1.14), new antibiotic prescription within 1–30 days (OR: 1.01; 95% CI: 0.87–1.16), or occurrence of pyelonephritis (Hazard Ratio (HR): 1.00; 95% CI: 0.67–1.48). Conclusion: These real-world data show that Canephron® is an effective, safe symptomatic treatment for acute cystitis or UTI. It should be considered as an alternative treatment, particularly to also strengthen antimicrobial stewardship strategies.
Highlights
Urinary tract infections (UTI) affect about 150 million people per year worldwide [1] and are among the leading reasons for treatment in adult primary care medicine [2]
As the risk of recurrence, as well as complications and the duration of the disease, are common reasons for prescribing antibiotics, we examined the effect of Canephron® monotherapy on sporadic and frequent recurrent UTIs, pyelonephritis, and the duration of UTI-related sick leave
Of the 69,450 patients not included in the analysis, as they had been prescribed neither Canephron® nor an antibiotic on the index date, 93% had no documented prescription data for UTI or acute cystitis, while only 7% had received another prescription (3% analgesics, 3% arbutin-containing drugs, and less than 1% other drugs)
Summary
Urinary tract infections (UTI) affect about 150 million people per year worldwide [1] and are among the leading reasons for treatment in adult primary care medicine [2]. The “EU Guidelines for the prudent use of antimicrobials in human health” (2017) generally recommend that prescribers avoid antibacterial treatment when there is only evidence of a viral infection or a self-limiting bacterial infection. Based on this need to avoid antibiotics where possible, non-antibiotic, symptomatic treatments have become an important treatment option for patients with uncomplicated UTIs. To date, a number of studies have compared the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs), e.g., ibuprofen [8,9] or diclofenac [10] to that of antibiotics. Canephron® has what are called “multi-target” properties, including spasmolytic [14], diuretic [15], anti-oxidative [16], anti-adhesive [17], anti-inflammatory, and anti-nociceptive effects [18]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
