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[2] [8] [7] [14] [24] Larger and higher-quality clinical trials of methenamine for UTI prevention have started to be published in the 2020s and it may soon be recommended by more medical guidelines. [2] [14] [19] [25] [15] Methenamine has been found to be more cost-effective than low-dose prophylactic antibiotics for preventing UTIs. [26]
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]
A UK study showed that methenamine is as effective 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.
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]
Uromune, also known by its developmental code name MV-140, is a polyvalent bacterial vaccine which is used and is being developed for prevention of recurrent urinary tract infections (UTIs). [ 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% ...
Fosfomycin can be used as an efficacious treatment for both UTIs and complicated UTIs including acute pyelonephritis. The standard regimen for complicated UTIs is an oral 3 g dose administered once every 48 or 72 hours for a total of 3 doses or a 6 g dose every 8 hours for 7–14 days when fosfomycin is given in IV form.