FRIDAY, March 11, 2022 (HealthDay Information) — Ladies stricken by frequent urinary tract infections typically take each day antibiotics to ward them off. However an outdated antibiotic various may work simply as properly, a brand new medical trial finds.
Researchers discovered that the medicine, referred to as methenamine, was comparable to straightforward, low-dose antibiotics in stopping ladies’s recurrent urinary tract infections (UTIs). Both therapy curbed the infections to round one per 12 months, 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 might probably forestall recurrent UTIs, however it’s not extensively used.
It is such an “outdated” drug, many docs right this moment have no idea about it, mentioned Dr.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 research, mentioned she reserves each day antibiotics as a final resort for stopping recurrent UTIs, favoring methenamine as an alternative.
A priority with each day antibiotic use is feeding antibiotic resistance, the place micro organism be taught to thwart the drugs used to kill them. Plus, Eilber mentioned, it disrupts the physique’s regular bacterial stability.
Dr. Chris Harding, a advisor urological surgeon at Freeman Hospital in the UK, led the trial.
He mentioned it “provides supportive proof for using methenamine and can be notably welcome to these ladies with recurrent UTI who wish to keep away from long-term antibiotic therapy.”
UTIs are exceedingly frequent and might have an effect on anybody, however are notably prevalent amongst ladies. Research counsel as much as 80% of girls develop a UTI in some unspecified time in the future, and about one-quarter of these ladies go on to have frequent recurrences.
Some signs embrace burning throughout urination, and feeling a powerful, persistent urge to urinate.
The brand new research — revealed on-line March 9 within theBMJ— concerned 240 ladies with recurring UTIs. Initially, they had been averaging round six UTIs per 12 months.
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 12 months of therapy, each teams noticed a major decline in UTI episodes. Ladies within the antibiotic group averaged just below one bout per individual for the 12 months, whereas these taking methenamine had simply over one episode per individual.
That could be a small distinction, Harding mentioned, and one which, primarily based on affected person focus teams, wouldn’t be thought-about “clinically significant.”
As for uncomfortable side effects, a small variety of ladies in every group reported issues like nausea, belly ache and diarrhea. Six ladies 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 12 months of therapy on this trial, ladies on antibiotics had been extra prone to harbor micro organism proof against at the very least 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 “must be interpreted with warning,” for the reason that trial was not primarily aimed toward gauging antibiotic resistance.
“Additional analysis is unquestionably indicated on this space,” he mentioned.
For now, ladies 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.
In addition to methenamine, one other various 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 ladies, Eilber mentioned, vaginal estrogen might assist forestall recurrent UTIs. After menopause, the vaginal tissue modifications in ways in which might foster the expansion of “unhealthy” micro organism.
Consultants additionally typically advise some self-care steps that may assist, like ingesting loads of water, urinating earlier than and after intercourse, and wiping entrance to again after utilizing the toilet.
Lots of the ladies within the present trial had been going by or previous menopause. However, Harding mentioned, his workforce didn’t have a look at the results of therapy in response to age. Nor did the research embrace 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 research 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, advisor 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
