Methenamine hippurate for preventing urinary tract infections

Prince of Wales Hospital, Spinal Injuries Unit, High St, Randwick, NSW, Australia, 2031.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 02/2007; 10(4):CD003265. DOI: 10.1002/14651858.CD003265.pub2
Source: PubMed


Bladder and kidney infections (urinary tract infections - UTI) can cause vomiting, pain, dysuria, septicaemia, fever and tiredness, and occasionally kidney damage. Some people are at high risk of repeated UTIs, and they are also more likely to have serious complications (including people with kidney problems, or people who have catheters to release urine). Long-term use of antibiotics can lead to resistance, so methenamine salts (methenamine or hexamine hippurate) are often used. This review identified 13 studies (2032 participants). Methenamine hippurate may be effective in preventing UTI in patients without renal tract abnormalities particularly when used for short term prophylaxis. It does not appear to be effective for long term prophylaxis in patients who have neuropathic bladder. There were few adverse effects.Additional well controlled randomised controlled trials are necessary in particular to clarify effectiveness for longer term prophylaxis in those without neuropathic bladder.

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