From the Guidelines
Preventive Medications for Urinary Tract Infections (UTIs) The most effective preventive medications for UTIs are Trimethoprim-Sulfamethoxazole (TMP-SMX) and Nitrofurantoin, which can be taken continuously or postcoitally, as well as Methenamine Hippurate as an alternative to prophylactic antibiotics in patients with intact bladder anatomy 1.
Medication Options
- TMP-SMX: 40 mg/200 mg once daily or 40 mg/200 mg 3 times weekly for continuous prophylaxis, or 40 mg/200 mg or 80 mg/200 mg once postcoitus for postcoital prophylaxis 1
- Nitrofurantoin: 50 mg or 100 mg daily for continuous prophylaxis, or 50 mg or 100 mg once postcoitus for postcoital prophylaxis 1
- Methenamine Hippurate: 1 g twice daily as an alternative to prophylactic antibiotics in patients with intact bladder anatomy 1
Non-Antibiotic Preventive Measures
- Cranberry products: containing proanthocyanidin levels of 36 mg can reduce recurrent UTIs in women, children, and individuals susceptible to UTIs 1
- Vaginal estrogen: can be used in postmenopausal women to prevent UTIs 1
- Increased water intake: an additional 1.5L of water can decrease UTIs in healthy women 1 It's essential to consult a healthcare provider to determine the best preventive strategy based on individual needs and medical history.
From the FDA Drug Label
Methenamine hippurate tablets is indicated for prophylactic or suppressive treatment of frequently recurring urinary tract infections when long-term therapy is considered necessary. The preventive medication for Urinary Tract Infections (UTIs) is:
- Methenamine Hippurate Key points to consider:
- This medication should only be used after eradication of the infection by other appropriate antimicrobial agents
- It should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria 2
From the Research
Preventive Medications for Urinary Tract Infections (UTIs)
The following medications are used as preventive measures for UTIs:
- Nitrofurantoin 3, 4
- Trimethoprim (or cotrimoxazole) 3, 5, 4
- Fosfomycin trometamol 3
- Methenamine hippurate 5
- Oral cephalosporins and quinolones (restricted to specific indications) 3
- Bactrim (a combination of trimethoprim and sulfamethoxazole) 4
- Amoxicillin clavulanic acid 4
Non-Antimicrobial Measures
Non-antimicrobial measures can also be used to prevent UTIs, including:
- Cranberry products 3, 6, 7
- Probiotics 3, 6, 7
- Vaginal substitution of oestriol in postmenopausal patients 3, 4
- Immunoprophylaxis 3
- Specific plant combinations 3
- Hyaluronic acid and chondroitin 6
- Acupuncture 6
- Herbs 6
- Topical estrogen in postmenopausal women 4
- Non-pharmacological methods to decrease urinary tract infections, such as education on proper hygiene and urinary habits 4