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[2] [15] UTI-free rates over 12 months were 43% with methenamine and 54% with antibiotics. [15] Besides effectiveness in terms of UTI prevention, methenamine demonstrated lower rates of bacterial resistance relative to antibiotic therapy in this trial and in other studies. [2] [14] [15]
[1] [2] [3] In clinical studies, it has been found to reduce total number of UTIs by about 70%, to increase UTI-free rates from around 25% to 57%, and to increase time to next UTI from about 1.6 months to 9.0 months. [2] [4] [5] [6] It has also been found to reduce subjective UTI symptoms, reduce antibiotic use, and improve quality of life.
Those who have bacteria in the urine but no symptoms should not generally be treated with antibiotics. [105] This includes those who are old, those with spinal cord injuries, and those who have urinary catheters. [106] [107] Pregnancy is an exception and it is recommended that women take seven days of antibiotics.
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The discovery of antimicrobial agents contributed significantly to UTI management during the 20th century. Nitrofurantoin emerged as the first practical and safe urinary antimicrobial agent, but it was with limited spectrum of activity. [48] Subsequently, in the 1970s, beta-lactam antibiotics and TMP/SMX became available for UTI therapy. [48]
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 ]
Trimethoprim (TMP) is an antibiotic used mainly in the treatment of bladder infections. [1] Other uses include for middle ear infections and travelers' diarrhea. [1] With sulfamethoxazole or dapsone it may be used for Pneumocystis pneumonia in people with HIV/AIDS. [1] [2] It is taken orally (swallowed by mouth). [1]
Roxithromycin is a semi-synthetic macrolide antibiotic. It is used to treat respiratory tract, urinary and soft tissue infections. Roxithromycin is derived from erythromycin, containing the same 14-membered lactone ring. but with an N-oxime side chain attached to the ring. Roxithromycin was patented in 1980 and approved for medical use in 1987. [1]
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