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Published on: August 5, 2010
Methenamine hippurate for preventing urinary tract infections
B B Lee1, J M Simpson, J C Craig
1Prince of Wales Hospital, Spinal Injuries Unit, High St, Randwick, NSW, Australia, 2031. blee@medicalinformatics.net
The Cochrane Database of Systematic Reviews
|October 19, 2007
Summary
Methenamine hippurate may prevent urinary tract infections (UTIs) in individuals without kidney abnormalities, especially for short-term use. It appears ineffective for those with neuropathic bladder or kidney issues, and adverse events are infrequent but poorly documented.
Area of Science:
- Pharmacology and Therapeutics
- Infectious Diseases
- Urology
Background:
- Methenamine salts are utilized as an alternative to antibiotics for preventing urinary tract infections (UTIs).
- Assessing the efficacy and safety of methenamine hippurate in UTI prevention is crucial.
Purpose of the Study:
- To evaluate the benefits and harms of methenamine hippurate for preventing UTIs.
- To determine its effectiveness across different patient populations.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) and quasi-RCTs.
- Searched multiple databases (CENTRAL, MEDLINE, EMBASE) and contacted manufacturers for studies up to September 2006.
- Data extraction and quality assessment by two independent authors; random effects model used for analysis.
Main Results:
- Thirteen studies involving 2032 participants were included; study quality was mixed.
- Methenamine hippurate showed potential benefit in patients without renal tract abnormalities (symptomatic UTI: RR 0.24, 95% CI 0.07 to 0.89).
- No significant benefit was observed in patients with known renal tract abnormalities or neuropathic bladder; adverse events were low but poorly described.
Conclusions:
- Methenamine hippurate may be effective for short-term UTI prophylaxis in patients without renal tract abnormalities.
- It is not effective in patients with neuropathic bladder or renal tract abnormalities.
- Further high-quality RCTs are needed to confirm efficacy, especially for long-term use.
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