📃 Paper Title: Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women: multicentre, open label, randomised, non-inferiority trial
🧍 Author: Harding
🕒 Year: 2021
📚 Journal: British Medical Journal
🌎 Country: United Kingdom
ㅤContext to the study:
Is there any evidence for the use of Hipprex in the management of recurrent UTIs in women?
ㅤ✅ Take-home message of study:
Methenamine Hippurate is a non-antibiotic medication that is as good as daily antibiotic prophylaxis for preventing recurrent UTIs in women.
ㅤ Multicentre, randomised, non-inferiority trial
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Study participants:
Inclusion:
Women (aged 18 years and over)
UK centres
Diagnoses with recurrent UTI (2 episodes in 6 months or 3 episodes in 12 months)
240 participants were randomly assigned (1:1) to either group from 8 UK centres.
205 participants met the intention to treat criteria, methenamine hippurate - 1g twice daily (n=103) or daily low-dose antibiotic prophylaxis (n=102) (nitrofurantoin, trimethoprim or cefalexin)
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Key study outcomes:
The primary outcome was the number of UTIs that required antibiotic treatment over a 12-month follow-up period.
Methenamine hippurate was deemed clinically non-inferior (1.38 episodes per year versus 0.89). The inferiority margin was set at one episode of UTI per year
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Study Limitations:
Neither the clinicians nor the patients were blinded to the participant treatment arm.
The cohort had broad inclusion criteria and various treatment options in the antibiotic arm.
The results are only generalisable to women and the UK population.
Long-term data on the efficacy and safety of methenamine hippurate is still unknown
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