Other considerations

Medicines adherence

Medicines adherence may be a problem for some people with medicines that require frequent dosing (for example, some antibiotics) or longer treatment duration. See the NICE guideline on medicines adherence.

No systematic reviews or randomised controlled trials (RCTs) were identified that addressed medicines adherence.

Resource implications

Antibiotic prophylaxis before or during short-term catheterisation in hospital

  • One RCT included in a systematic review (Lusardi et al. 2013) of hospitalised adults with a short-term catheter compared antibiotic prophylaxis (levofloxacin or ciprofloxacin) with placebo calculated hospital stay in presurgery and postsurgery phases. There was no statistically significant difference in mean presurgical or postsurgical stay between the placebo group and either the levofloxacin or ciprofloxacin groups (low quality evidence).

  • In a second included RCT comparing antibiotic prophylaxis with placebo, the mean hospital stay was significantly higher in the placebo group compared with the intervention group (8 days [plus or minus 1.4 days] compared with 7 days [plus or minus 1.2 days], p=0.0002; low quality evidence). Febrile morbidity and urinary tract infection (UTI) prolonged hospitalisation significantly to a mean stay of 9.2 days ([plus or minus 1.6 days], p<0.05).

  • In a third included RCT comparing antibiotic prophylaxis with placebo, the average hospital stay was 6 days and 5.6 days for abdominal hysterectomy, and 6.1 days and 7.6 days for vaginal hysterectomy patients, in the prophylaxis group and placebo groups respectively.

  • Recommended antibiotics (nitrofurantoin, trimethoprim, penicillins, cephalosporins, fluoroquinolones and aminoglycosides) are available as generic formulations, see the Drug Tariff for costs.