Antibiotics Combined With Estrogen Use In The Treatment Of Postmenopausal Women With Urinary Tract Infection: A Systemic Review And A Meta-analysis

Background and Aim:The incidence of urinary tract infection is increasing,especially in postmenopausal women,the efficacy and risk of using antibiotics combined with estrogen in treating postmenopausal women with urinary tract infection are controversial.We used the meta method to analyze the cure rate,improvement rate,total effective rate,relapse rate and estrogen increase in the treatment of urinary tract infection in postmenopausal women,so as to evaluate its risk and benefit.Methods:We use the following electronic databases to retrieve the relevant literature::Cochrane Library Pub Medn Web of Science Embase,China knowledge Network,Weipu.com,Wanfang Database and Chinese Biomedical Database.The retrieval time is from the establishment of the database to December 2017,and there are no language restrictions for the retrieval.The etiological criteria for the diagnosis of urinary tract infection or the current criteria for the etiological diagnosis of urinary tract infection,issued by the national health and family planning commission of china,must be randomized controlled trial(RCT)and cohort study.Or treatment group: estrogen combined with antibiotics;Control group: antibiotics alone.Furantoin et al.5)outcome index: cure rate,improvement rate,total effective rate,recurrence rate,estrogen level,cure standard: after 2 weeks of treatment,the clinical symptoms of the patients disappeared,and the urine routine results indicated that the patients had no recurrence after one year follow-up.Improvement criteria: the same cure standard,but there is recurrence half a year later,recurrence criteria: urinary tract infection within 6 months ≥ 2 times,or 1 year or more attacks ≥ 3 times.Urine examination found abnormal;frequent urination,urination,urinal pain and other clinical symptoms.One of the two criteria was the total effective rate of recurrence =cure rate.We use Revman5.3 software to carry out Meta analysis on the relevant dataincluded in the literature.Results:We selected 10 articles from all the articles that met the inclusion criteria,including 913 patients.No apparent publication bias was found.No obvious partial published.Antibiotic group and antibiotics combined with estrogen group,the cure rate,improvement rate,total effective rate,recurrence rate of OR were 4.01(95% CI2.93-5.49),0.61(95% CI,5.94 0.43-0.85)(95% CI 3.98-8.87),0.18(95% CI0.13-0.26).According to the data,the curative effect of estrogen combined with antibiotic group was better than that of single antibiotic group.The MD values of estrogen level before and after treatment were-0.26(95% CI0.75-0.24),11.11(95% CI 7.22-14.99).Conclusion:The results of meta analysis showed that the efficacy of low-dose estrogen combined with antibiotics in the treatment of postmenopausal women with urinary tract infection was better than that with antibiotics alone.Therefore,it is recommended that low dose of estrogen should be added to the treatment of postmenopausal women with sensitive antibiotics for urinary tract infection.However,because estrogen is related to the incidence of endometrial carcinoma and breast cancer,attention should be paid to the way and time of its use.Since the clinical evidence of estrogen in the treatment of postmenopausal women with urinary tract infection is based on only a few small studies,further research in this field is needed to confirm the efficacy,safety and optimal dose of treatment.