Effectiveness of a combination of nasturtium herb and horseradish root (Angocin® Anti-Infekt N) compared to antibiotics in managing acute and recurrent urinary tract infections : retrospective real-world cohort study

Abstract

Background: The goal of this study was to evaluate whether the medical recommendation of Angocin® Anti-Infekt N, compared to standard antibiotic treatment shortly after the diagnosis of a urinary tract infection (UTI) or cystitis, is negatively associated with an early, sporadic, or recurrent UTI, subsequent antibiotic prescriptions, pyelonephritis as a renal complication, or UTI-associated sick leave. Methods: This retrospective cohort study was based on data from the IQVIATM Disease Analyzer database and included patients diagnosed with acute UTI or cystitis by physicians in Germany between 2005 and 2021, who were prescribed either Angocin® or standard antibiotics within 4 days after diagnosis. Patients prescribed antibiotics were matched to those prescribed Angocin® (5:1) using propensity scores. Univariable logistic and Cox regression models were used to investigate the association between Angocin® prescription and the defined study outcomes. The effects of Angocin® were adjusted for age, sex, insurance status, index diagnosis, and physician specialty. Results: A total of 2277 Angocin® patients and 11,385 antibiotic patients were available for analysis. Compared to antibiotic prescriptions, Angocin® prescription was associated with significantly lower odds of an early relapse within 1–30 days after the index date (odds ratio (OR): 0.74; 95% confidence interval (CI): 0.62–0.87; p < 0.001), further sporadic UTI within 31–365 days after the index date (OR: 0.68; 95% CI: 0.58–0.78; p < 0.001), and recurrent UTI (OR: 0.63; 95% CI: 0.48–0.82; p < 0.001). This was also accompanied by reduced antibiotic prescriptions (1–30 days: OR: 0.63; 95% CI: 0.53–0.74, p < 0.001; 31–365 days: OR: 0.56; 95% CI: 0.49–0.64, p < 0.001). A strong, but due to the low incidence, not significant, negative association was observed between Angocin® prescription and the occurrence of pyelonephritis (hazard ratio (HR): 0.67; 95% CI: 0.43–1.06; p = 0.073). Conclusions: The results of this real-world data study demonstrate that Angocin® can be an effective therapeutic option for managing acute and recurrent UTIs and serves as an alternative therapy to antibiotics.