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Published on: August 5, 2010
Long-term treatment with methenamine hippurate in recurrent urinary tract infection
Abstract:
Twenty-four patients with a history of recurrent urinary tract infection and in whom residual urine was considered to be a factor of importance for chronicity, have been treated for an average of 16 months with 1 g methenamine hippurate morning and evening. No patient had urinary calculus at the commencement of treatment and neither did any patient have an indwelling catheter. In patients without urinary tract infection or in whom abacteriuria was achieved with methenamine hippurate, the number of reinfections was reduced by approximately two thirds compared to periods prior to treatment. No patient was completely free from infection throughout the whole treatment period. However, in no case did bacteria with extensive resistance appear. When urinary tract infection was treated with methenamine hippurate, abacteriuria was achieved in only 6 of 14 patients. It would therefore seem that this agent is only of limited value for treatment of established infection. In the event of manifest infection it would appear appropriate to treat the infection primarily with antibiotics and to use methenamine hippurate for prophylaxis when abacteriuria has been achieved. No patient developed urinary calculus during treatment with methenamine hippurate and no deterioration of renal function or haematological change was observed.
Insights
Methenamine hippurate significantly reduced recurrent urinary tract infections (UTIs) by two-thirds in patients when abacteriuria was achieved. It is more effective for prophylaxis than treating established infections.
Area of Science:
- Urology
- Infectious Diseases
- Pharmacology
Background:
- Recurrent urinary tract infections (UTIs) pose a significant clinical challenge.
- Residual urine is a key factor contributing to chronic UTIs.
- Methenamine hippurate is a potential prophylactic agent for UTIs.
Purpose of the Study:
- To evaluate the efficacy of methenamine hippurate in preventing recurrent UTIs.
- To assess the role of methenamine hippurate in treating established UTIs.
- To determine the safety profile of long-term methenamine hippurate use.
Main Methods:
- A prospective study involving 24 patients with a history of recurrent UTIs.
- Patients received 1g methenamine hippurate twice daily for an average of 16 months.
- Outcomes included reinfection rates, achievement of abacteriuria, and development of bacterial resistance.
Main Results:
- Methenamine hippurate reduced reinfections by approximately two-thirds in patients achieving abacteriuria.
- Abacteriuria was achieved in only 6 of 14 patients with established UTIs.
- No significant increase in bacterial resistance or adverse events like urinary calculus was observed.
Conclusions:
- Methenamine hippurate is effective for UTI prophylaxis once abacteriuria is achieved.
- Its efficacy in treating established UTIs is limited.
- Combination therapy with antibiotics for active infections followed by methenamine hippurate prophylaxis is recommended.
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