Antiseptic methenamine hippurate is just as effective as antibiotics to prevent recurrent urinary tract infections in women, found a published trial. BMJ today.
Using it as an alternative to antibiotics can help alleviate global warming vaccinesay the researchers.
More than half mata they have at least one urinary tract infection (UTI) in their lifetime, and relapse (defined as having at least three recurrences per year or two relapses in the last six months) occurs in about one-fourth of women with one episode.
Current guidelines recommend regular antiretroviral therapy as a prophylactic measure. remedy for regular UTI. But such long-term use of antibiotics is associated with bacterial resistance, so research on non-immune methods is urgently needed.
Methenamine hippurate is a drug that inhibits urination, inhibits the growth of certain bacteria. Previous studies have shown that it may be effective in preventing UTIs, but the evidence is unfounded and further tests are needed.
So a team of British researchers, led by doctors and scientists from Newcastle-upon-Tyne, set out to test whether methenamine hippurate is an effective alternative to regular antibiotics to prevent UTI infection in women.
Their study was based on 240 women (18 years or older) with urinary tract infections need prophylactic treatment. On average before the entrance exam these women experienced more than six UTI events each year.
Women were taken from UK secondary care centers between June 2016 and June 2018 and were randomly assigned to regular antibiotics (102 women) or regular methenamine hippurate (103 women) for 12 months, with monthly evaluation for up to 18 months.
The non-depreciating rate, which is defined after a series of patient focus group meetings, varies by one percentage point UTI per year.
During the 12-month follow-up period, the UTI score was 0.89 percent per year in the placebo group and 1.38 percent in the methenamine group — a mean difference of 0.49 percent per year.
This small difference between the two groups was less than the specific dose of one UTI per year, indicating that methenamine is no worse than antibiotics in preventing urinary tract infections.
Methenamine is also associated with a reduction in antimicrobial activity and similar levels of adverse reactions and treatment satisfaction compared to conventional antibiotics.
And the results remained the same after further research, such as excluding days of taking antibiotics for urinary tract infections, adding weight to the study.
Researchers have shown that data on the long-term health of methenamine hippurate are limited, and they accept some experimental limitations, including blindness and differences in antibiotics, which may affect their results.
They also noted that four participants who were given methenamine hippurate were hospitalized for UTI, and six participants who were given methenamine hippurate reported fever during a UTI (febrile UTI) condition.
However, they say this is an improved test that represents more women with UTI frequently seen more frequently in the NHS routine.
Thus, they say their results “may support a practical change in terms of UTI prevention methods and provide patients and physicians with improved daily alternatives. vaccineencourages them to pursue strategies to avoid long-term use of the virus. “
The information provided by this trial “may encourage patients and clinicians to consider methenamine hippurate as the first line of treatment for UTI in women,” they added.
“Although the results require careful interpretation, they are consistent with others, and this new study increases confidence that methenamine hippurate may be offered as an alternative for women who need prevention and recurrent urinary tract infections,” she said. hear Australian researchers in the related editor.
The suitability of the non-urinary tract components (part of the urinary tract infection) used in this trial to capture clinically significant differences between treatments could lead to controversy, they said.
However, they agreed that the decision on antibiotics should be repeated urinary tract infection They agreed with the decision-making process between each patient and their doctor, and said the test “would help inform this important discussion.”
Alternative prophylactic antibiotics for the treatment of recurrent urinary tract infections in women: multicentre, open label, randomized, infertility test, BMJ (2022). DOI: 10.1136 / bmj-2021-068229
British Medical Journal
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