Antiseptic Drug As Good As Antibiotics For Preventing Recurrent Utis
11 March, 2022By Steve Ford
The antiseptic drug methenamine hippurate is as good as antibiotics for preventing recurrent urinary tract infections in women, according to UK researchers.
They said their findings could support a change in practice and that using the drug as an alternative to antibiotics may also help tackle the global burden of antibiotic resistance.
This trial adds to the evidence base for the use of methenamine hippurate for prophylactic treatment
The study authors highlighted that over half of women have at least one urinary tract infection in their lifetime, and recurrence occurs in about a quarter of women who have one episode.
Current guidelines, including those of the National Institute for Health and Care Excellence, recommend daily low dose antibiotics as the standard preventive treatment for recurrent UTI.
However, such long-term use of antibiotics has been linked to antibiotic resistance, noted the researchers, meaning non-antibiotic alternatives needed to be urgently identified.
Their paper, published in the British Medical Journal, explained that methenamine hippurate was a drug that sterilises urine, stopping the growth of certain bacteria.
In it, they said that previous studies had shown that it could be effective in preventing UTIs, but that the evidence was inconclusive and further randomised trials were needed.
The study was funded by the National Institute for Health Researchs Health Technology Assessment programme.
Selection Criteria And Methods
One reviewer screened citations and selected studies. In the first level of screening, titles and abstracts were reviewed and potentially relevant articles were retrieved and assessed for inclusion. The final selection of full-text articles was based on the inclusion criteria presented in .
Context And Policy Issues
A urinary tract infection may involve the kidneys , or the bladder, urethra, or prostate . Bacteria are most often the cause of a UTI. Healthcare-associated UTIs are the fourth most common type of healthcare-associated infection and approximately 80% of healthcare-associated UTIs are related to the use of indwelling urinary catheters. A catheter-associated UTI is diagnosed when infection symptoms are observed within 48 hours of catheterization and a urine specimen tests positive for infection-causing bacteria. CAUTIs have been associated with harms such as increased morbidity and mortality and costs such as increased length of stay and hospital costs.
A urinary catheter provides a way for bacteria to enter the urinary tract more easily. These infections most often result from bacteria already present on the patient in the meatal, rectal or vaginal areas, and less often from contamination of the catheterization equipment or the hands of the healthcare personnel therefore, several antiseptic agents or procedures are available to clean these areas prior to the insertion of urinary catheters with the aim of reducing the incidence of CAUTIs.
The objective of this report is to summarize the evidence regarding the clinical effectiveness and the evidence-based guidelines regarding antisepsis procedures or agents to reduce infection in patients undergoing urinary catheter insertion.
Parsley Water Has A Cleansing Effect:
An important part of parsley is Apigenin. It is a diuretic and is anti-inflammatory.
- The bacteria residing inside your bladder or urethra can be flushed out by these diuretics.
- Being anti-inflammatory, it will relieve the infection and also aid your body in healing.
- Corn silk tea is also effective in fighting UTIs since it possesses the same properties as that of parsley.
How Long Does A Uti Last
Urinary tract infections usually go away after the first few days of antibiotics treatment. Depending on the severity of the infection, they may last a bit longer. If you often get UTIs, your healthcare provider may prescribe low-dose antibiotics for a few months at a time. If you have a UTI, over-the-counter products may help ease your symptoms while you receive antibiotic treatment.
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How Do You Treat Utis
Urinary tract infections are usually treated with antibiotics prescribed by a healthcare provider. The length of antibiotic treatment depends on the severity of the infection, whether you have had a UTI before, and if your symptoms go away quickly. If you are prescribed antibiotics for a UTI, it is important to take them as instructed by your healthcare provider.
There are additional medications and treatments available over-the-counter that may help ease symptoms and pain or prevent additional UTIs such as urinary pain relief tablets, cranberry pills, and heating pads.
Drink Buchu Tea To Heal Your Urinary System
- Boil a glass of water. Remove it from the flame .
- Add 2 tablespoons of dried buchu to it and let soak for 5 to 10 minutes.
- Strain it and drink 1 to 2 cups a day.
Buchu, also known as bookoo or bucco, is a herb that is very effective in treating urinary tract disorders.25 It has antimicrobial, anti-inflammatory, and diuretic properties that cleanse and heal your urinary tract.26
Tip: Add equal amount of uva ursi to make the drink more effective.
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Critical Appraisal Of Individual Studies
The included network meta-analysis was appraised using the ISPOR Indirect Treatment Comparison/Network Meta-Analysis Study Questionnaire and the systematic review was critically appraised using AMSTAR II. Summary scores were not calculated for the included studies rather, a review of the strengths and limitations of each included study were described narratively.
Antiseptic Drug As Good As Antibiotics For Preventing Recurrent Urinary Infections
10 March 2022
A new NIHR-funded study published in The BMJ, has shown the antiseptic drug methenamine hippurate is as good as antibiotics for preventing recurrent urinary tract infections in women.
Researchers led by The Newcastle upon Tyne Hospitals NHS Foundation Trust say its use as an alternative to antibiotics could also help tackle the global burden of antibiotic resistance.
Over half of women have at least one urinary tract infection in their lifetime and recurrence occurs in about a quarter of women who have one episode.
Current guidelines recommend daily low dose antibiotics as the standard preventive treatment for recurrent UTI. But such long term use of antibiotics has been linked to antibiotic resistance, so research into non-antibiotic alternatives is urgently needed.
Methenamine hippurate is a drug that sterilises urine, stopping the growth of certain bacteria. Previous studies have shown that it could be effective in preventing UTIs, but the evidence is inconclusive.
The study team recruited 240 women aged 18 or over with recurrent urinary tract infections, requiring prophylactic treatment. Patients were randomly assigned to daily antibiotics or daily methenamine hippurate for 12 months, with three monthly assessments up to 18 months.
Chris Harding, Chief Investigator of the study, said: This trial provides the highest quality evidence to date detailing the clinical benefit of a non-antibiotic preventative treatment .
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How Is Urinary Tract Infection Usually Treated
Most vets choose antibiotics as the go-to treatment for urinary tract infections in dogs. However, the problem with antibiotics is that they kill all kinds of bacteria not only the bad ones.
Considering that many urinary tract infections stem from bladder inflammation, using antibiotics to treat them is counter-productive.
A damaged gut flora can cause recurring UTIs, not to mention that antibiotics need to reach a certain concentration in the bloodstream to be more effective.
In a 2014 review of antibiotics for UTIs conducted by the University of Copenhagen, the authors found that theres little published evidence relating to antibiotic treatments of UTIs in dogs and cats. Well-designed clinical trials on the duration of treatment are required to create evidence-based treatment protocols.
Antibiotic resistance is also an issue. The more antibiotics your dog takes, the more resistant it becomes to bacteria.
Thats why dog owners are turning to natural remedies.
What About Antibiotic Resistance
Resistance rates for antibiotics are always variable based on local patterns in the community and specific risk factors for patients, such as recent antibiotic use, hospital stay or travel. If you have taken an antibiotic in the last 3 months or traveled internationally, be sure to tell your doctor.
High rates of antibiotic resistance are being seen with both ampicillin and amoxicillin for cystitis , although amoxicillin/clavulanate may still be an option. Other oral treatments with reported increasing rates of resistance include sulfamethoxazole and trimethoprim and the fluoroquinolones. Resistance rates for the oral cephalosporins and amoxicillin/clavulanate are still usually less than 10 percent.
Always finish taking your entire course of antibiotic unless your doctor tells you to stop. Keep taking your antibiotic even if you feel better and you think you dont need your antibiotic anymore.
If you stop your treatment early, your infection may return quickly and you can develop resistance to the antibiotic you were using previously. Your antibiotic may not work as well the next time you use it.
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Urinary Tract Antiseptics : Definition Dose Classification Mechanism Of Action Antibacterial Spectrum Therapeutic Uses Clinical Uses Side Effects Drug Interactions & Contraindications
- Urinary Tract Antiseptics are anti microbial agents that do not achieve antibacterial levels in the circulation, but get concentrated in the urine only with little or no systemic antibacterial effect.
- Like many other drugs, Urinary Tract Antiseptics are concentrated in the kidney tubules, and are useful mainly in lower urinary tract infection.
- Nalidixic acid can also be considered to be a urinary antiseptic.
Mechanism of action
- Methenamine is inactive as such. It decomposes slowly at an acidic pH of 5.5 or less in urine to release formaldehyde which is toxic to bacteria & inhibits all bacteria.
- Nitrofurantoin sensitive bacteria reduce the drug to a highly active intermediate that inhibits various enzymes and damages bacterial DNA.
- Urea-splitting bacteria that alkalinize the urine, such as Proteus species, are usually resistant to the action of methenamine. It is primarily bacteriostatic, but may be cidal at higher concentrations and in acidic urine.
- Nitrofurantoin inhibits many gram-negative bacteria but due to development of resistance, activity is now restricted largely to E. coli. Gram-positive cocci are typically susceptible.
Nitrofurantoin is indicated for uncomplicated lower urinary tract infection oniy but it is infrequently used now.
Methenamine is primarily used for chronic suppressive therapy to reduce the frequency of UTIs.
Nitrofurantoin may cause following side effects :
How To Use Methenamine Hippurate
Take this medication by mouth as directed by your doctor. Dosage is based on the brand of methenamine you are prescribed, your medical condition, and your response to treatment. For children, dosage is also based on age and weight.
Methenamine works better if your urine is more acidic. Your doctor may test the acidity of your urine . If necessary, your doctor may recommend ways to increase urine acidity rel=nofollow> vitamin C/drinking cranberry juice, limiting foods that decrease acidity/increase alkalinity such as milk products/most fruits, adjusting alkalinizing medications). See also Drug Interactions section. Follow your doctors instructions.
For the best effect, take this drug at evenly spaced times. To help you remember, take this medication at the same time every day.
Keep taking this medication for the full time prescribed, even if you feel well. Skipping doses or stopping the medication too early may allow bacteria to continue to grow, which may result in a return of the infection and make the bacteria more difficult to treat . Do not take more of this drug than directed because it may increase your chance of side effects.
Tell your doctor if symptoms of a urinary tract infection return .
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Urinary Tract Infection Treatment Products At Walgreens
Urinary tract infections are infections that occur when bacteria enter a persons urethra and infect the urinary tract. UTIs can be painful and uncomfortable and may require medical care. Most UTIs can be treated at home with antibiotics from your healthcare provider, and symptoms may be eased with certain pain-relief products. Walgreens offers options to detect infections and prevent or ease symptoms, such as UTI test strips, urinary pain relief tablets and chewable cranberry tablets.
Summary Of Study Characteristics
presents a table of the main study findings and authors conclusions.
Clinical Effectiveness of Antiseptic Agents or Procedures
The results of the NMA did not show any statistically significant differences in the incidence of CAUTIs between the different cleaning methods. Although the differences in effectiveness were not statistically significantly different, the authors used probability sequencing to rank the interventions for effectiveness from one to seven. Chlorhexidine ranked first, clean water was second, soap and water third. Iodine, saline, routine meatal care, and antibacterial use ranked from four to seven.
The results of the meta-analysis comparing water and antiseptics showed no statistically significant difference in the rate of CAUTI between groups . Subgroup analyses were conducted comparing water with povidone-iodine and water with chlorhexidine and the lack of statistically significant differences in bacteriuria rates remained. Based on the data provided in the individual studies included in the SR, the authors concluded that either tap water or sterile water could be used as an option for periurethral cleaning prior to urinary catheter insertion.
No relevant evidence-based guidelines regarding the use of antiseptic procedures or agents to reduce infection in patients undergoing urinary catheter insertion were identified therefore, no summary can be provided.
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Methenamine Hippurate Is A Drug That Sterilises Urine Stopping The Growth Of Certain Bacteria Previous Studies Have Shown That It Could Be Effective In Preventing Utis But The Evidence Is Inconclusive And Further Randomised Trials Are Needed
The current guidelines as the standard preventive treatment for recurrent urinary tract infection recommend daily low dose antibiotics.
However, such long term use of antibiotics has been linked to antibiotic resistance, so research into non-antibiotic alternatives is urgently needed.
Methenamine hippurate is a drug that sterilises urine, stopping the growth of certain bacteria. Previous studies have shown that it could be effective in preventing UTIs, but the evidence is inconclusive and further randomised trials are needed.
A team of UK researchers, led by clinicians and scientists from Newcastle-upon-Tyne, set out to test if methenamine hippurate is an effective alternative to standard antibiotic treatment for preventing recurrent UTI in women.
The findings of the study were published in the journal The BMJ.
Their findings are based on 240 women with recurrent urinary tract infections requiring prophylactic treatment. On average before trial entry, these women experienced over six UTI episodes per year.
Women were recruited from UK secondary care centres between June 2016 and June 2018 and were randomly assigned to daily antibiotics or daily methenamine hippurate for 12 months, with three monthly assessments up to 18 months.
The non-inferiority margin, defined after a series of patient focus group meetings, was a difference of one UTI episode per year.
What Researchers Found
In their study, the researchers concluded that methenamine hippurate could be a viable alternative to daily antibiotics for women with recurrent UTIs.
In the study, women taking antibiotics had .89 incidents and those taking methenamine hippurate had 1.38 incidents. There were more UTI episodes in women using the methenamine hippurate, but the researchers determined it to be non-inferior to antibiotic prophylaxis.
This trial provides the highest quality evidence to date detailing the clinical benefit of a non-antibiotic preventive treatment, said Dr. Christopher Harding, the lead author of the study, a urological surgeon and the chairman of the European Association of Urology Guidelines. Previous work has suggested that methenamine may be useful, but this trial provides further high quality evidence.
Our results could support a change in practice in terms of preventive treatments for recurrent UTI and provide patients and clinicians with a credible alternative to daily antibiotics, Harding told Healthline. The information provided by this trial will allow clinicians and patients to undertake a shared decision-making process relating to UTI preventive treatments.
The study showed a small numerical difference in UTI incidence between the daily antibiotics and methenamine hippurate groups, but the potential trade-off includes the avoidance of antibiotic consumption, which is closely associated with antimicrobial resistance development, he added.
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Drink Plenty Of Fluids
Dehydration is linked to an increased risk of UTIs.
This is because regular urination can help flush bacteria from the urinary tract to prevent infection. When youre dehydrated, you arent urinating as often, which can create a breeding ground for bacteria.
A examined nursing home residents and administered a drinking schedule to participants to increase their fluid intake. Following the schedule decreased UTIs requiring antibiotics by 56%.
In a 2020 randomized control trial , 140 premenopausal participants prone to UTIs took part in a 12-month study to test if a higher fluid intake would decrease their risk of recurrent cystitis and, in turn, their risk of developing a UTI. Researchers found that an increase in fluid intake led to a decrease in UTI frequency.
To stay hydrated and meet your fluid needs, its best to drink water throughout the day and always when youre thirsty.
Benefits of drinking more fluids for UTI
Drinking plenty of liquids can decrease your risk of UTIs by making you pee more, which helps remove bacteria from your urinary tract.
evidence suggests that increasing your intake of vitamin C could protect against UTIs.
Vitamin C is thought to work by increasing the acidity of urine, killing off the bacteria that cause infection.
An older 2007 study of UTIs in pregnant women looked at the effects of taking 100 milligrams of vitamin C every day.
Fruits and vegetables are especially high in vitamin C and are a good way to increase your intake.
What Is A Uti
A UTI is caused by bacteria that get into your urine and travel up to your bladder, according to the Urology Care Foundation.
While anyone can get UTIs, theyre much more common in the female urinary system since the urethra is shorter, allowing bacteria to travel quicker to the bladder.
- pain in the lower abdomen and possibly the lower back
- burning or pain when urinating
- increased frequency of urinating
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