Elsevier, The Lancet Obstetrics, Gynaecology, & Women's Health, Available online 11 February 2026In this target trial emulation study, prophylactic antibiotic use did not raise the risk of hospital admission due to antibiotic-resistant or urinary tract infections, however it did increase the risk of antibiotic resistance in uropathogens and multidrug resistance detected in urine cultures. This study offers new data on the absolute risk and number needed to harm for individual antibiotic resistance, which can inform shared decision-making discussions on preventing recurrent urinary tract infections (rUTIs).