Presentation Authors: Sarah Prattley*, Francesca New, Rob Geraghty, Bhaskar Somani, Southampton, United Kingdom
Introduction: Recurrent urinary tract infections (rUTIs) can be difficult to treat although there are some non-antibiotic therapies it is not always clinically efficacious. We therefore conducted a systematic review to look at the available evidence on the use of vaccines for recurrent UTIs.
Methods: A systematic review was conducted for all English language articles identified by a literature search of EMBASE, CINAHL, MEDLINE, Scopus, Biomed Central, and Web of Science between inception and July 2018. Data extraction was carried out independently by two authors for patient demographics, vaccine type, method of administration, bacterial content, efficacy, adverse events, discontinuation and follow-up.
Results: After initial identification of 168 studies, 36 abstracts were screened, 25 full articles were assessed, and 19 studies were included for final review. A total of 3275 patients, 2019 patients in the vaccine group and 1256 patients in the control/antibiotic/placebo/observational group were included (from 19 studies) reviewing 4 different vaccine types (Uromune, UroVaxom, Solco-Urovac and ExPEC4V). There were 3 studies in Uromune (n= 594 patients), 11 in UroVaxom (n = 1176 patients), 4 in Solco-Urovac (n= 157 patients) and 1 in ExPEC4V (n= 92 patients) groups. _x000D_
The overall efficacy for UTI free rates across all vaccines varied from 22.2% to 87.5%, and 52% to 90.3% over 3-6 months and 6-12 months respectively. Discontinuation due to potential adverse reaction was only reported in 13 cases of vaccination across all studies. The adverse events were Clavien I and varied from 4.4% to 13% across studies with the most frequent being gastrointestinal upset, pain at injection site and vaginal irritation, depending on vaccine used.
Conclusions: Our review suggests that vaccines have a promising role in the prevention of recurrent UTIs over a short-term period of up to 12 months. Although the clinical efficacy is good with a low risk of morbidity, further long-term follow-up studies will be required before they can be routinely used in clinical practice.