Reid 1992.

Methods	Study design: parallel RCT Study duration: recruitment date not reported, patients were followed for 6 months (final follow up date unknown)
Participants	Setting: outpatient Country: Canada Premenopausal women with signs and symptoms of an acute lower UTI with dysuria, frequency, urgency, or nocturia, but no flank pain or fever and positive screening results for bacteriuria using a leukocyte esterase strip Number: treatment group (19); control group (21) Mean age ± SD: 23 ± 4.4 years Exclusion criteria: pregnancy; diabetes; known allergy to fluoroquinolones or TMP/SMX; history of urinary cancer or other urinary tract abnormalities; use of medications other than the study medications
Interventions	Treatment group Lactobacillus casei var rhamnosus GR‐1 and Lactobacillus fermentum B‐54 vaginal suppository 1.6 x 109 organisms/capsule, intravaginally, twice a week for 2 weeks then at the end of each of the next 2 months Control group Sterilised skim milk placebo vaginal suppository intravaginally, twice a week for 2 weeks then at the end of each of the next 2 months
Outcomes	UTI recurrence defined as both asymptomatic and symptomatic bacteriuria with urine cultures performed routinely during follow up visits Adverse effects determined by questioning the patients about signs of rash, vomiting, diarrhoea, nausea, irritation, or discharge
Notes	Funding was provided by grants from Merck‐Frosst, Canada and University Research Incentive Fund of Ontario, Canada The authors were contacted 7 May 2012 with the following questions: Did the patients enrolled in this trial have a history of recurrent UTI? How was the random number sequence generated? Which of the groups involved in the trial were blinded? No response received
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	"...each patient randomly received one capsule..." Page 12 ‐ Study design
Allocation concealment (selection bias)	Low risk	Allocation was blinded randomly by hospital pharmacists
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Insufficient information to permit judgement
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Insufficient information to permit judgement
Incomplete outcome data (attrition bias) All outcomes	High risk	“Six patients decided not to take suppositories...” Page 13 ‐ Results “...31 of the original 41 patients complied well...” Page 13 ‐ Results “...nine did not return for long‐term follow up so could not be included in recurrent UTI analysis” Table Page 13
Selective reporting (reporting bias)	Unclear risk	All outcomes appear to be reported in full. No published protocol cited or available.
Other bias	High risk	Sponsored by Merck Frosst Used skim milk placebo – unknown effect on promotion or inhibition of UTI or lactobacillus growth/colonisation