Drug Could Be Non-Antibiotic Alternative to Treat UTIs

FRIDAY, March 11, 2022 (HealthDay News) — Women tormented by frequent urinary tract infections typically take every day antibiotics to ward them off. But an outdated antibiotic various may work simply as properly, a brand new medical trial finds.

Researchers discovered that the medicine, referred to as methenamine, was comparable to straightforward, low-dose antibiotics in stopping girls’s recurrent urinary tract infections (UTIs). Either remedy curbed the infections to round one per yr, on common.

Methenamine is a long-established medicine that works by making the urine extra acidic and stopping bacterial development. Studies have proven that it could possibly forestall recurrent UTIs, but it surely’s not extensively used.

It’s such an “outdated” drug, many medical doctors in the present day have no idea about it, mentioned Dr. Karyn Eilber, a urologist at Cedars-Sinai Medical Center in Los Angeles.

Eilber, who was not concerned within the new research, 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 study to thwart the drugs used to kill them. Plus, Eilber mentioned, it disrupts the physique’s regular bacterial stability.

Dr. Chris Harding, a guide urological surgeon at Freeman Hospital within the United Kingdom, led the trial.

He mentioned it “provides supportive proof for the usage of methenamine and might be notably welcome to these girls 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 girls. Studies recommend as much as 80% of girls develop a UTI sooner or later, and about one-quarter of these girls go on to have frequent recurrences.

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

The new research — revealed on-line March 9 in theBMJ— concerned 240 girls with recurring UTIs. At the beginning, they have been averaging round six UTIs per yr.

Half of the ladies have 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 major decline in UTI episodes. Women 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 is a small distinction, Harding mentioned, and one which, primarily based on affected person focus teams, wouldn’t be thought-about “clinically significant.”

As for unintended effects, a small variety of girls in every group reported issues like nausea, belly ache and diarrhea. Six girls developed a UTI with fever, and 4 wanted to be hospitalized — all of whom have been within the methenamine group.

Whether treating extra UTIs with methenamine will assist battle the issue of antibiotic resistance is an open query. During the one yr of remedy on this trial, girls on antibiotics have been extra prone to harbor micro organism proof against at the very least one antibiotic. But that modified when their micro organism have been sampled six months later: Those who had taken methenamine had extra antibiotic-resistant bugs.

Harding mentioned that discovering “ought to be interpreted with warning,” because the trial was not primarily aimed toward gauging antibiotic resistance.

“Further analysis is unquestionably indicated on this space,” he mentioned.

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

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

Besides 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 girls, Eilber mentioned, 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.

Experts 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 lavatory.

Many of the ladies within the present trial have been going by or previous menopause. But, Harding mentioned, his crew didn’t have a look at the results of remedy in response to 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 danger of recurrent UTI.

The research was funded by the U.Ok. National Institute for Health Research.

More info

The U.S. Office on Women’s Health 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 Center, Los Angeles; BMJ, March 9, 2022, on-line