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TMP/SMX is commonly used due to its ability to achieve high concentrations in urinary tract tissues and urine. This antibiotic combination demonstrates notable efficacy in both the treatment and prophylaxis of recurrent urinary tract infections. [12] Common adverse effects include nausea, vomiting, rash,pruritus, and photosensitivity. [26]
The costs of methenamine for long-term UTI prophylaxis can be significant. [2] However, a 2024 study found that methenamine was more cost-effective than low-dose prophylactic antibiotics for prevention of UTIs. [26]
As a prophylactic against UTIs, nitrofurantoin was similarly effective to other antibiotics, with a UTI risk ratio of 0.38. [27] [28] Taken daily long-term as a prophylactic, there were no differences in effectiveness between different doses of nitrofurantoin (50 mg/day, 75 mg/day, 100 mg/day, or 50 mg twice daily). [27]
It is used to treat urinary tract infections, methicillin-resistant Staphylococcus aureus (MRSA) skin infections, travelers' diarrhea, respiratory tract infections, and cholera, among others. [ 2 ] [ 7 ] It is used both to treat and prevent pneumocystis pneumonia and toxoplasmosis in people with HIV/AIDS and other causes of immunosuppression. [ 2 ]
A urinary tract infection (UTI) is an infection that affects a part of the urinary tract. [1] Lower urinary tract infections may involve the bladder ( cystitis ) or urethra ( urethritis ) while upper urinary tract infections affect the kidney ( pyelonephritis ). [ 10 ]
Antibiotic prophylaxis refers to, for humans, the prevention of infection complications using antimicrobial therapy (most commonly antibiotics). Antibiotic prophylaxis in domestic animal feed mixes has been employed in America since at least 1970.
A UK study showed that methenamine is as effective as daily low-dose antibiotics at preventing UTIs among women who experience recurrent UTIs. As methenamine is an antiseptic, it may avoid the issue of antibiotic resistance. [16] [17] Methenamine acts as an over-the-counter antiperspirant due to the astringent property of formaldehyde. [18]
The efficacy of pivmecillinam in treating females eighteen years of age or older with uncomplicated UTIs was assessed in three controlled clinical trials comparing different pivmecillinam dosing regimens to placebo, to another oral antibacterial drug and to ibuprofen (an anti-inflammatory drug). [3]
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