Drug Could Be Non-Antibiotic Alternative to Treat UTIs

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FRIDAY, March 11, 2022 (HealthDay Information) — Ladies suffering from frequent urinary tract infections usually take day by day antibiotics to ward them off. However an outdated antibiotic various may work simply as properly, a brand new clinical trial finds.

Researchers found that the medicine, referred to as methenamine, was comparable to plain, low-dose antibiotics in stopping girls’s recurrent urinary tract infections (UTIs). Both therapy 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. 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It is such an “outdated” drug, many medical doctors at this time have no idea about it, mentioned Dr. Karyn Eilber, a urologist at Cedars-Sinai Medical Middle in Los Angeles.

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

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

He mentioned it “provides supportive proof for using methenamine and shall be significantly welcome to these girls with recurrent UTI who wish to keep away from long-term antibiotic therapy.”

UTIs are exceedingly widespread and may have an effect on anybody, however are significantly prevalent amongst girls. Research recommend as much as 80% of ladies develop a UTI in some unspecified time in the future, and about one-quarter of these girls go on to have frequent recurrences.

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

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

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

Over one yr of therapy, each teams noticed a big 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 mentioned, and one which, primarily based on affected person focus teams, wouldn’t be thought of “clinically significant.”

As for unwanted side effects, a small variety of girls in every group reported issues like nausea, abdominal pain and diarrhea. Six girls 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 therapy on this trial, girls on antibiotics had been extra more likely 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 mentioned that discovering “must be interpreted with warning,” because the trial was not primarily aimed toward gauging antibiotic resistance.

“Additional analysis is certainly 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.

Moreover 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 adjustments in ways in which could 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 toilet.

Most of the girls within the present trial had been going by means of or previous menopause. However, Harding mentioned, his staff didn’t take 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 danger 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, marketing consultant 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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