The Effect of Canephron N in Preventing Urinary Tract Infection: A Systematic Review and Meta-Analysis.

AIM: Urinary tract infections (UTIs) are among the most common bacterial infections, particularly in women, with significant implications for quality of life and healthcare costs. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of Canephron N in preventing UTIs, comparing its effects to antibiotics and assessing its potential as an antibiotic-sparing alternative. METHODS: We conducted a comprehensive literature search across multiple databases (Embase, PubMed, Cochrane, Web of Science, and ClinicalTrials.gov) up to July 2025, following PRISMA guidelines. Risk of bias was assessed using Cochrane RoB 2 for RCTs and ROBINS-I for non-randomized studies. Meta-analyses were performed using random-effects models, with outcomes including bacteriuria presence, Acute Cystitis Symptom Scores (ACSS), and adverse events. Heterogeneity was quantified via the I2 statistic. RESULTS: From 246 initially identified records, 12 studies (eight RCTs, three observational, one retrospective; n = 3821 patients) were included. Canephron N demonstrated non-inferiority to antibiotics in reducing UTI recurrence (6-month rates: 8.9% vs. 17.8%) and symptom severity (ACSS reduction: -1.9 to -2.3 points). Pooled analyses revealed significant difference in bacteriuria clearance (RR: 1.34, 95% CI: 1.20-1.48, p < 0.0001) and no significant adverse events (RR: 0.90, 95% CI: 0.69-1.18, p = 0.43), though gastrointestinal events were less frequent with Canephron (4.8% vs. 7.1%). Heterogeneity was moderate (I2 = 72% for bacteriuria outcomes), attributed to variability in study designs and comparators. CONCLUSION: Canephron N is an effective and safe alternative to antibiotics for preventing uncomplicated UTIs, with comparable symptom relief and a lower ecological impact.