FRIDAY, March 11, 2022 (HealthDay Information) — Ladies affected by frequent urinary tract infections usually take each day antibiotics to ward them off. However an previous antibiotic different would possibly work simply as effectively, a brand new medical trial finds.
Researchers discovered that the medicine, referred to as methenamine, was comparable to plain, low-dose antibiotics in stopping girls’s recurrent urinary tract infections (UTIs). Both therapy curbed the infections to round one per yr, on common.
Methenamine is a long-established medicine that works by making the urine extra acidic and stopping bacterial progress. Research have proven that it will probably stop recurrent UTIs, but it surely’s not broadly used.
It is such an “previous” drug, many docs right now have no idea about it, mentioned Dr. Karyn Eilber, a urologist at Cedars-Sinai Medical Heart in Los Angeles.
Eilber, who was not concerned within the new examine, mentioned she reserves each day antibiotics as a final resort for stopping recurrent UTIs, favoring methenamine as a substitute.
A priority with each day antibiotic use is feeding antibiotic resistance, the place micro organism study to thwart the medicines used to kill them. Plus, Eilber mentioned, it disrupts the physique’s regular bacterial stability.
Dr. Chris Harding, a marketing consultant urological surgeon at Freeman Hospital in the UK, led the trial.
He mentioned it “provides supportive proof for using methenamine and will likely be significantly welcome to these girls with recurrent UTI who wish to keep away from long-term antibiotic therapy.”
UTIs are exceedingly widespread and might have an effect on anybody, however are significantly prevalent amongst girls. Research counsel as much as 80% of girls develop a UTI in some unspecified time in the future, and about one-quarter of these girls go on to have frequent recurrences.
Some signs embody burning throughout urination, and feeling a robust, persistent urge to urinate.
The brand new examine — revealed on-line March 9 within theBMJ— concerned 240 girls with recurring UTIs. Initially, they had been averaging round six UTIs per yr.
Half of the ladies had been randomly assigned to each day low-dose antibiotic therapy, whereas the opposite half took methenamine twice a day.
Over one yr of therapy, each teams noticed a major decline in UTI episodes. Ladies within the antibiotic group averaged just below one bout per particular person for the yr, whereas these taking methenamine had simply over one episode per particular person.
That may be a small distinction, Harding mentioned, and one which, based mostly on affected person focus teams, wouldn’t be thought of “clinically significant.”
As for uncomfortable side effects, a small variety of girls in every group reported issues like nausea, belly ache and diarrhea. Six girls developed a UTI with fever, and 4 wanted to be hospitalized — all of whom had been within the methenamine group.
Whether or not treating extra UTIs with methenamine will assist battle the issue of antibiotic resistance is an open query. In the course of the one yr of therapy on this trial, girls on antibiotics had been extra more likely to harbor micro organism immune to not less than one antibiotic. However that modified when their micro organism had been sampled six months later: Those that had taken methenamine had extra antibiotic-resistant bugs.
Harding mentioned that discovering “needs to be interpreted with warning,” because the trial was not primarily geared toward gauging antibiotic resistance.
“Additional analysis is unquestionably indicated on this space,” he mentioned.
For now, girls ought to know there are alternatives for stopping frequent UTIs, the specialists mentioned.
“Low-dose antibiotics ought to undoubtedly not be the primary line,” Eilber mentioned.
Moreover methenamine, one other different is to take an antibiotic solely after intercourse. (Sexual exercise can encourage UTI-causing micro organism to maneuver into the urethra, the tube that releases urine from the physique.)
For postmenopausal girls, Eilber mentioned, vaginal estrogen could assist stop recurrent UTIs. After menopause, the vaginal tissue modifications in ways in which could foster the expansion of “unhealthy” micro organism.
Consultants additionally typically advise some self-care steps that may assist, like consuming loads of water, urinating earlier than and after intercourse, and wiping entrance to again after utilizing the toilet.
Lots of the girls within the present trial had been going by means of or previous menopause. However, Harding mentioned, his workforce didn’t take a look at the results of therapy in response to age. Nor did the examine embody males. So it isn’t clear whether or not the findings would apply to older adults, one other group at elevated threat of recurrent UTI.
The examine was funded by the U.Ok. Nationwide Institute for Well being Analysis.
Extra info
The U.S. Workplace on Ladies’s Well being has extra on urinary tract infections.
SOURCES: Chris Harding, MD, marketing consultant urological surgeon, Freeman Hospital, Newcastle upon Tyne, U.Ok.; Karyn Eilber, MD, urologist, Cedars-Sinai Medical Heart, Los Angeles; BMJ, March 9, 2022, on-line
