Drug May Be Non-Antibiotic Various to Deal with UTIs

FRIDAY, March 11, 2022 (HealthDay Information) — Ladies suffering from frequent urinary tract infections typically take every day antibiotics to ward them off. However an previous antibiotic different may work simply as nicely, a brand new medical trial finds.

Researchers discovered that the remedy, known as methenamine, was comparable to plain, 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 remedy that works by making the urine extra acidic and stopping bacterial progress. Research have proven that it could forestall recurrent UTIs, but it surely’s not broadly used.

It is such an “previous” drug, many docs as we speak have no idea about it, stated Dr. Karyn Eilber, a urologist at Cedars-Sinai Medical Heart in Los Angeles.

Eilber, who was not concerned within the new research, stated she reserves every day antibiotics as a final resort for stopping recurrent UTIs, favoring methenamine as a substitute.

A priority with every day antibiotic use is feeding antibiotic resistance, the place micro organism be taught to thwart the drugs used to kill them. Plus, Eilber stated, it disrupts the physique’s regular bacterial steadiness.

Dr. Chris Harding, a guide urological surgeon at Freeman Hospital in the UK, led the trial.

He stated it “provides supportive proof for the usage of methenamine and will probably be notably welcome to these ladies with recurrent UTI who wish to keep away from long-term antibiotic therapy.”

UTIs are exceedingly frequent and may have an effect on anybody, however are notably prevalent amongst ladies. Research recommend as much as 80% of girls develop a UTI sooner or later, and about one-quarter of these ladies go on to have frequent recurrences.

Some signs embody burning throughout urination, and feeling a robust, persistent urge to urinate.

The brand new research — printed on-line March 9 within theBMJ— concerned 240 ladies with recurring UTIs. At first, they have been averaging round six UTIs per 12 months.

Half of the ladies have been randomly assigned to every day low-dose antibiotic therapy, whereas the opposite half took methenamine twice a day.

Over one 12 months of therapy, each teams noticed a big decline in UTI episodes. Ladies within the antibiotic group averaged slightly 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 stated, and one which, primarily based on affected person focus teams, wouldn’t be thought-about “clinically significant.”

As for negative 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 have 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. Throughout the one 12 months of therapy on this trial, ladies on antibiotics have been extra prone to harbor micro organism proof against at the least one antibiotic. However that modified when their micro organism have been sampled six months later: Those that had taken methenamine had extra antibiotic-resistant bugs.

Harding stated that discovering “needs to be interpreted with warning,” because the trial was not primarily geared toward gauging antibiotic resistance.

“Additional analysis is certainly indicated on this space,” he stated.

For now, ladies ought to know there are alternatives for stopping frequent UTIs, the consultants stated.

“Low-dose antibiotics ought to positively not be the primary line,” Eilber stated.

In addition to methenamine, one other different 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 stated, vaginal estrogen could assist forestall recurrent UTIs. After menopause, the vaginal tissue modifications in ways in which could foster the expansion of “dangerous” micro organism.

Specialists 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 lavatory.

Most of the ladies within the present trial have been going via or previous menopause. However, Harding stated, his crew didn’t have a look at the consequences of therapy in line with age. Nor did the research embody 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.Okay. 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, guide urological surgeon, Freeman Hospital, Newcastle upon Tyne, U.Okay.; Karyn Eilber, MD, urologist, Cedars-Sinai Medical Heart, Los Angeles; BMJ, March 9, 2022, on-line

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