FRIDAY, March 11, 2022 (HealthDay Information) — Girls suffering from frequent urinary tract infections usually take every day antibiotics to ward them off. However an previous antibiotic various may work simply as properly, a brand new scientific trial finds.
Researchers discovered that the treatment, known as methenamine, was comparable to straightforward, low-dose antibiotics in stopping ladies’s recurrent urinary tract infections (UTIs). Both remedy curbed the infections to round one per yr, on common.
Methenamine is a long-established treatment that works by making the urine extra acidic and stopping bacterial progress. Research have proven that it could possibly forestall recurrent UTIs, nevertheless it’s not extensively used.
It is such an “previous” drug, many docs at this time 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 examine, mentioned she reserves every day antibiotics as a final resort for stopping recurrent UTIs, favoring methenamine as an alternative.
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 mentioned, 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 mentioned it “provides supportive proof for using methenamine and might be significantly welcome to these ladies with recurrent UTI who wish to keep away from long-term antibiotic remedy.”
UTIs are exceedingly widespread and may have an effect on anybody, however are significantly prevalent amongst ladies. Research recommend as much as 80% of ladies 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 embody burning throughout urination, and feeling a powerful, persistent urge to urinate.
The brand new examine — printed on-line March 9 within theBMJ— concerned 240 ladies with recurring UTIs. Initially, they had been averaging round six UTIs per yr.
Half of the ladies had been randomly assigned to every day low-dose antibiotic remedy, whereas the opposite half took methenamine twice a day.
Over one yr of remedy, each teams noticed a big decline in UTI episodes. Girls within the antibiotic group averaged slightly below one bout per individual for the yr, whereas these taking methenamine had simply over one episode per individual.
That could be a small distinction, Harding mentioned, and one which, based mostly on affected person focus teams, wouldn’t be thought-about “clinically significant.”
As for unwanted effects, a small variety of ladies in every group reported issues like nausea, stomach 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. Through the one yr of remedy on this trial, ladies on antibiotics had been extra more likely to harbor micro organism proof against no less than 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 geared toward gauging antibiotic resistance.
“Additional analysis is certainly 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.
Apart from 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 “dangerous” micro organism.
Consultants additionally usually advise some self-care steps that may assist, like consuming loads of water, urinating earlier than and after intercourse, and wiping entrance to again after utilizing the lavatory.
Lots of the ladies within the present trial had been going by means of or previous menopause. However, Harding mentioned, his crew didn’t have a look at the results of remedy in line with age. Nor did the examine embody males. So it is not clear whether or not the findings would apply to older adults, one other group at elevated threat of recurrent UTI.
The examine was funded by the U.Ok. Nationwide Institute for Well being Analysis.
The U.S. Workplace on Girls’s Well being has extra on urinary tract infections.
SOURCES: Chris Harding, MD, guide 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