Drug May Be Non-Antibiotic Various to Deal with UTIs

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FRIDAY, March 11, 2022 (HealthDay Information) — Ladies stricken by frequent urinary tract infections usually take every day antibiotics to ward them off. However an previous antibiotic various would possibly 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 therapy 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 development. Research have proven that it will probably stop recurrent UTIs, however it’s not extensively used.

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It is such an “previous” drug, many docs at the moment have no idea about it, stated Dr. Karyn Eilber, a urologist at Cedars-Sinai Medical Middle 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 study to thwart the medicines used to kill them. Plus, Eilber stated, it disrupts the physique’s regular bacterial stability.

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 can be significantly welcome to these ladies with recurrent UTI who wish to keep away from long-term antibiotic therapy.”

UTIs are exceedingly widespread and might have an effect on anybody, however are significantly prevalent amongst ladies. Research recommend as much as 80% of girls 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 embrace burning throughout urination, and feeling a powerful, persistent urge to urinate.

The brand new research — revealed on-line March 9 within theBMJ— concerned 240 ladies with recurring UTIs. Firstly, they had been averaging round six UTIs per yr.

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

Over one yr of therapy, each teams noticed a major decline in UTI episodes. Ladies within the antibiotic group averaged just below one bout per individual for the yr, whereas these taking methenamine had simply over one episode per individual.

That may be a small distinction, Harding stated, and one which, based mostly on affected person focus teams, wouldn’t be thought-about “clinically significant.”

As for unintended 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 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. In the course of the one yr of therapy on this trial, ladies on antibiotics had been extra prone 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 stated that discovering “must be interpreted with warning,” for the reason that trial was not primarily geared toward gauging antibiotic resistance.

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

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

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

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 stated, vaginal estrogen might assist stop recurrent UTIs. After menopause, the vaginal tissue adjustments in ways in which might foster the expansion of “unhealthy” micro organism.

Consultants additionally usually 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.

Lots of the ladies within the present trial had been going by way of or previous menopause. However, Harding stated, his group didn’t take a look at the consequences of therapy in response to age. Nor did the research embrace males. So it isn’t clear whether or not the findings would apply to older adults, one other group at elevated danger of recurrent UTI.

The research was funded by the U.Okay. Nationwide Institute for Well being Analysis.

Extra data

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 Middle, Los Angeles; BMJ, March 9, 2022, on-line

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