Single-dose antibiotic therapy for urinary infections during pregnancy: A systematic review and meta-analysis of randomized clinical trials.

BACKGROUND: During pregnancy, urinary infections are an important cause of maternofetal morbidity and mortality and may lead to several complications. OBJECTIVE: To verify whether the use of antibiotic therapy in a single dose when compared with multiple doses in lower tract urinary infections during pregnancy is effective to obtain microbiologic cure. SEARCH STRATEGY: Online databases were searched. Keywords used were "single-drug dose", "antibiotic", "fosfomycin", "amoxicillin", "trimethoprim", "pregnancy", and "urinary tract infection". SELECTION CRITERIA: Studies were included if they were randomized controlled trials, the population was pregnant woman, microbiologic cure was attained, and one of the treatment groups received single-dose antibiotic therapy. DATA COLLECTION AND ANALYSIS: Preselected studies have been independently read by pairs, and data were extracted according to a predetermined sheet. The Cochrane tool was used for the risk of bias. MAIN RESULTS: A total of 1063 women from nine studies were included. The primary outcome was the microbiologic cure attested by urine culture. When compared with the multiple-day use of antibiotics, the single-dose treatment has shown statistically similar results in reaching culture cure (odds ratio 1.02, 95% confidence interval 0.73-1.44). CONCLUSION: The current study has shown that the use of single-dose treatment for lower tract urinary infections during pregnancy can be recommended, especially using fosfomycin. SYSTEMATIC REVIEW REGISTRATION: This review has not been registered.

Abyssinone V, a prenylated flavonoid isolated from the stem bark of Erythrina melanacantha increases oxidative stress and decreases stress resistance in Caenorhabditis elegans.

OBJECTIVES: Recent studies showed that distinct extracts of Erythrina species used in the traditional medicine of sub-Saharan Africa are protective against stress conditions. However, the underlying molecular mechanisms as well as relevant compounds remain unclear. METHODS: We used the model organism Caenorhabditis elegans to investigate compounds isolated from the stem bark of Erythrina melanacantha (abyssinone V (1), abyssinon-4'O-methylether (2), sigmoidin B-4'O-methylether (3), glabranin (4), 8-prenylnaringenin (5), citflavanone (6), exiguaflavanone (7) and homoeriodictyol (8)). Antioxidative capacity in vitro (trolox equivalent antioxidative capacity assay) and modulation of oxidative stress in vivo (2', 7'-dichlorofluorescein assay) were investigated; stress resistance was analysed using the nucleic acid stain SYTOX green. KEY FINDINGS: None of the prenylated flavonoids caused protection against thermal stress; in contrast, most of the compounds (1, 4, 5, 8) decreased stress resistance. None of the compounds decreased the accumulation of reactive oxygen species, but abyssinone V (1) caused an increase in oxidative stress. In line with these results, none of these compounds showed radical-scavenging effects in vitro. CONCLUSIONS: The stem bark of E. melanacantha contains various prenylated flavonoids, but no compound protected C. elegans against stress conditions. In contrast, abyssinone V increases oxidative stress and reduces stress resistance in this model organism.