FRIDAY, March 11, 2022 (HealthDay Information) — Girls affected by frequent urinary tract infections typically take day by day antibiotics to ward them off. However an outdated antibiotic various would possibly work simply as nicely, a brand new medical trial finds.
Researchers found that the remedy, referred to as methenamine, was comparable to plain, 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 remedy that works by making the urine extra acidic and stopping bacterial development. Research have proven that it may possibly forestall recurrent UTIs, but it surely’s not extensively used.
It is such an “outdated” drug, many medical doctors immediately have no idea about it, stated Dr.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 examine, stated she reserves day by day antibiotics as a final resort for stopping recurrent UTIs, favoring methenamine as an alternative.
A priority with day by 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 stability.
Dr. Chris Harding, a advisor urological surgeon at Freeman Hospital in the UK, led the trial.
He stated it “provides supportive proof for the usage of methenamine and shall be notably welcome to these ladies with recurrent UTI who wish to keep away from long-term antibiotic remedy.”
UTIs are exceedingly widespread and might have an effect on anybody, however are notably prevalent amongst ladies. Research counsel 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 robust, persistent urge to urinate.
The brand new examine — printed 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 day by 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 just below one bout per particular person for the yr, whereas these taking methenamine had simply over one episode per particular person.
That could be a small distinction, Harding stated, and one which, primarily based on affected person focus teams, wouldn’t be thought of “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 remedy on this trial, ladies on antibiotics had been extra prone to harbor micro organism immune to at the least 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 “ought to be interpreted with warning,” because the 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 positively 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 forestall recurrent UTIs. After menopause, the vaginal tissue modifications in ways in which might foster the expansion of “dangerous” micro organism.
Specialists additionally typically 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 toilet.
Most of the ladies within the present trial had been going by or previous menopause. However, Harding stated, his crew didn’t take a look at the consequences of remedy in response to 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.Okay. Nationwide Institute for Well being Analysis.
Extra data
The U.S. Workplace on Girls’s Well being has extra on urinary tract infections.
SOURCES: Chris Harding, MD, advisor 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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