Condition

Urinary Tract Infection

UTI - Bacterial infection of the urinary system

4.5B
People Affected
150
Active Trials
404M
New Cases/Year
300K
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Nitrofurantoin
88% Effectiveness• 92% Confidence• 70% Safety• 50 trials• 75K participants
HIGH EvidenceExcellent ValueDose: 100mg twice daily or 50mg four times daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
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Morphine💊
Antibiotics💉
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70
DangerousModerateSafe

Time to Effect

1-2 days

Duration

3-7 days

Response Rate

90%

Remission Rate

85%

Number Needed to Treat (NNT)

3

Number Needed to Harm (NNH)

8

Common Side Effects:

Nausea: 15%
Headache: 10%
Diarrhea: 8%
Vaginitis: 5%

Annual Cost of Care

Drug Cost

$15

Monitoring

$160

Side Effects

$10

Total Annual

$185

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.005

Cost per Remission

$217.65

Cost per Responder

$205.56

Treatment Outcomes
Primary Outcomes
ACSS Total Score (Acute Cystitis Symptom Score)ACSS Total Score: 12/18
-75% (-9 points)
Dysuria SeverityDysuria Severity: 2/3
-75% (-1.5 points)
Urine Leukocyte CountUrine WBCs: 100/hpf
-95% (-95/hpf)
Urine Bacterial Concentration10^5 CFU/mL
-99.99% (-99,990 CFU/mL)
Secondary Benefits
PGI-S Score (Patient Global Impression of Severity)PGI-S Score: 5/7
-60% (-3 points)
UTI-Specific Quality of Life ScoreUTI-QoL Score: 40/100
+87.5% (+35 points)
C-Reactive Protein (CRP)CRP: 15 mg/L
-80% (-12 mg/L)
Common Side Effects
Nausea
+15%
Headache
+10%
Diarrhea
+8%

Clinical Trial Phases:

Phase 4
2
Fosfomycin
85% Effectiveness• 89% Confidence• 72% Safety• 36 trials• 25K participants
HIGH EvidenceGood ValueDose: 3g single dose
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
72
DangerousModerateSafe

Time to Effect

1-2 days

Duration

Single dose

Response Rate

88%

Remission Rate

82%

Number Needed to Treat (NNT)

3

Number Needed to Harm (NNH)

7

Common Side Effects:

Diarrhea: 9%
Nausea: 6%
Headache: 4%

Annual Cost of Care

Drug Cost

$50

Monitoring

$160

Side Effects

$10

Total Annual

$220

Cost-Effectiveness

GOOD

QALYs Gained

0.005

Cost per Remission

$268.29

Cost per Responder

$250

Treatment Outcomes
Primary Outcomes
UTI Symptom Severity Score (ACSS, 0-18 total)15/18 (moderate-severe symptoms)
-80% (-12 points)
Dysuria Severity (0-4 scale)3/4 (severe dysuria)
-90% (-2.7 points)
Urine Bacterial Load10^5 CFU/mL
-99.9% (-99,900 CFU/mL)
Secondary Benefits
Urinary Frequency/Urgency Score (0-4 scale)3/4 (severe frequency/urgency)
-83.3% (-2.5 points)
Impact on Daily Activities (0-10 scale, higher means more impact)8/10 (significant interference)
-75% (-6 points)
Common Side Effects
Diarrhea
+9%
Nausea
+6%
Headache
+4%

Clinical Trial Phases:

Phase 4
3
Trimethoprim/Sulfamethoxazole
82% Effectiveness• 88% Confidence• 68% Safety• 43 trials• 60K participants
HIGH EvidenceExcellent ValueDose: 160mg/800mg twice daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
68
DangerousModerateSafe

Time to Effect

1-2 days

Duration

3-7 days

Response Rate

85%

Remission Rate

80%

Number Needed to Treat (NNT)

3

Number Needed to Harm (NNH)

9

Common Side Effects:

Nausea: 12%
Rash: 8%
Diarrhea: 7%
Photosensitivity: 3%

Annual Cost of Care

Drug Cost

$15

Monitoring

$160

Side Effects

$10

Total Annual

$185

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.004

Cost per Remission

$231.25

Cost per Responder

$217.65

Treatment Outcomes
Primary Outcomes
Dysuria Severity Score (0-10 NRS)7.0 points
-80% (-5.6 points)
Urinary Frequency/Urgency Score (0-10 NRS)6.5 points
-75% (-4.9 points)
Probability of Persistent Bacteriuria Post-Treatment100%
-85% (-85 percentage points)
Overall UTI Symptom Score (e.g., UTISA, 0-30 scale)20 points
-70% (-14 points)
Secondary Benefits
UTI Recurrence Rate (within 28-42 days)25%
-80% (-20 percentage points)
UTI-Related Hospitalization Rate (within 90 days)5%
-70% (-3.5 percentage points)
Health-Related Quality of Life (EQ-5D VAS, 0-100)55 points
+20% (+11 points)
Common Side Effects
Nausea
+12%
Rash
+8%
Diarrhea
+7%

Clinical Trial Phases:

Phase 4
4
Cephalexin
80% Effectiveness• 85% Confidence• 70% Safety• 12 trials• 35K participants
HIGH EvidenceExcellent ValueDose: 250-500mg four times daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
70
DangerousModerateSafe

Time to Effect

1-2 days

Duration

5-7 days

Response Rate

82%

Remission Rate

78%

Number Needed to Treat (NNT)

4

Number Needed to Harm (NNH)

8

Common Side Effects:

Nausea: 10%
Diarrhea: 8%
Stomach pain: 4%

Annual Cost of Care

Drug Cost

$20

Monitoring

$160

Side Effects

$10

Total Annual

$190

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.004

Cost per Remission

$243.59

Cost per Responder

$231.71

Treatment Outcomes
Primary Outcomes
Urine Bacterial Count>10^5 Colony Forming Units (CFU)/mL
-99.9% (Reduction to <10^3 CFU/mL)
UTI Symptom Severity Score10/15 (on a validated 0-15 scale, higher is worse)
-75% (-7.5 points)
Dysuria Visual Analog Scale (VAS) Score7/10 (moderate-severe pain)
-60% (-4.2 points)
Secondary Benefits
Duration of Dysuria72 hours
-60% (-43.2 hours)
UTI-Specific Quality of Life Score40/100 (lower score indicating poorer QoL)
+50% (+20 points)
Urine White Blood Cell (WBC) Count>10 WBC/High Power Field (HPF)
-90% (Reduction to <5 WBC/HPF)
Common Side Effects
Nausea
+10%
Diarrhea
+8%
Stomach pain
+4%

Clinical Trial Phases:

Phase 4