The drugs may also help solve the global problem of antibiotic resistance, researchers say.
Antiseptic drugs can be used as alternatives to antibiotics to prevent recurrent urinary tract infections (UTIs) and prevent antibiotic resistance, findings of a study published in The BMJ show.
Guidelines recommend a daily low dose of antibiotics as standard preventative treatment for recurrent UTIs, but long-term antibiotic use has been linked to antibiotic resistance.
Methenamine hippurate can sterilize urine and stop the growth of certain bacteria. Previous studies have shown that the drug can prevent UTIs. However, the evidence has not been conclusive and further randomized trials are needed.
Researchers in Newcastle, England aimed to test whether methenamine hippurate could effectively prevent recurrent UTIs in women as an alternative to standard antibiotic treatment.
The study included 240 women, aged 18 and over, with recurrent UTIs requiring prophylactic treatment. On average and before the trial, individuals experienced more than 6 episodes of UI per year.
Individuals were recruited from secondary care centers between June 2016 and June 2018.
The women were divided into 2 groups: 102 women were randomly assigned to receive daily antibiotics and 103 were randomly assigned to receive methenamine hippurate daily.
They took the drug for 12 months, with 3 monthly assessments up to 18 months.
The non-inferiority margin was a difference of 1 UI episode per year. The margin was set after a series of patient focus group meetings.
Over the 12-month treatment period, the UTI rate was 0.89 episodes per person-year in the antibiotic group and 1.38 in the methenamine group, the difference being 0.49 episodes per person -year.
Notably, the difference between the 2 groups was below the predefined threshold of 1 UTI episode per year, suggesting that methenamine hippurate was no worse than antibiotics at preventing UTIs.
Methenamine hippurate was also associated with reduced antibiotic consumption and similar levels of adverse events and treatment satisfaction compared to daily antibiotics.
And the results were similar after other analyses, such as excluding days of taking antibiotics for UTIs, adding weight to the results.
Additionally, the investigators said data regarding the long-term safety of methenamine hippurate is sparse and they acknowledged the limitations of the trial, including lack of blinding and differences in antibiotics. prescribed, which could have affected the results of the trial.
Additionally, they stated that 4 people taking methenamine hippurate were admitted to hospital for a urinary tract infection, and 6 people who received methenamine hippurate reported fevers during an episode of urinary tract infection.
They added that the trial was well designed to accurately represent the wide range of people with recurrent UTIs.
The investigators said they hoped the study results would support a change in how treatments for recurrent UTIs are prevented.
Antiseptic drug as effective as antibiotics in preventing recurrent urinary tract infections. Eurek alert. Press release. March 9, 2022. Accessed March 10, 2022. https://www.eurekalert.org/news-releases/945617