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Editor's Correspondence
Nov 26, 2012

Lactobacilli vs Antibiotics to Prevent Recurrent Urinary Tract Infections: An Inconclusive, Not Inferior, Outcome

Author Affiliations

Author Affiliation: Division of Urology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.

Arch Intern Med. 2012;172(21):1690-1694. doi:10.1001/archinternmed.2012.4427

The timely report on preventive treatments for recurrent urinary tract infections (UTIs), Beerepoot et al1(p711) concluded that oral lactobacilli, when compared with trimethoprim-sulfamethoxazole, “did not meet the noninferiority criteria.”1(p711) Although this phraseology is technically correct, its meaning is somewhat opaque, and others have misunderstood the study to demonstrate that lactobacilli “were inferior to”2 or “not as effective as”3 antibiotic prophylaxis. Greater clarity may have been achieved by following the example of the Consolidated Standards of Reporting Trials (CONSORT) Group and declaring the data “inconclusive,” since the 95% confidence interval for between-treatment difference in number of symptomatic UTIs overlapped the noninferiority margin.4