Drug May Be Non-Antibiotic Various to Deal with UTIs

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FRIDAY, March 11, 2022 (HealthDay Information) — Girls stricken by frequent urinary tract infections typically take every day antibiotics to ward them off. However an outdated antibiotic different may work simply as properly, a brand new scientific trial finds.

Researchers discovered that the remedy, 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 remedy that works by making the urine extra acidic and stopping bacterial progress. Research have proven that it might forestall recurrent UTIs, however it’s not broadly used.

It is such an “outdated” drug, many medical doctors right this moment have no idea about it, stated Dr.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 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 stated, it disrupts the physique’s regular bacterial steadiness.

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

He stated it “provides supportive proof for using methenamine and will probably be notably welcome to these girls with recurrent UTI who need to keep away from long-term antibiotic therapy.”

UTIs are exceedingly widespread and might have an effect on anybody, however are notably prevalent amongst girls. Research counsel as much as 80% of ladies develop a UTI sooner or later, and about one-quarter of these girls go on to have frequent recurrences.

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

The brand new research — revealed on-line March 9 within theBMJ— concerned 240 girls 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. Girls within the antibiotic group averaged slightly 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 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 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 prone to harbor micro organism proof against at the very 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 “needs to 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 stated.

For now, girls 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 different 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 stated, vaginal estrogen might assist forestall recurrent UTIs. After menopause, the vaginal tissue modifications in ways in which might foster the expansion of “unhealthy” micro organism.

Consultants additionally typically 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.

Most of the girls within the present trial had been going by way of or previous menopause. However, Harding stated, his staff didn’t take a look at the results of therapy based on age. Nor did the research embrace males. So it is not 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. 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.Ok.; Karyn Eilber, MD, urologist, Cedars-Sinai Medical Middle, Los Angeles; BMJ, March 9, 2022, on-line



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