How can I prevent urinary tract infections (UTIs)?

From the Guidelines

To prevent urinary tract infections, drink an additional 1.5L of water daily to flush bacteria from your urinary system, as recommended by the most recent guidelines 1. This approach is supported by the latest research, which emphasizes the importance of adequate hydration in reducing the risk of UTIs.

• Urinate when you feel the need and always empty your bladder completely to prevent bacterial growth.
• After using the toilet, wipe from front to back to prevent bacteria from the anal region reaching the urethra.
• Urinate before and after sexual activity to help flush out bacteria.
• Consider wearing cotton underwear and loose-fitting clothes to keep the area around the urethra dry.
• Avoid potentially irritating feminine products like douches and powders in the genital area.
• Cranberry products may help prevent UTIs by making it harder for bacteria to attach to urinary tract walls, though scientific evidence is mixed 1.
• If you're prone to recurrent UTIs, your doctor might recommend preventive antibiotics like nitrofurantoin or trimethoprim-sulfamethoxazole, either as a daily low dose or to take after sexual activity 1.
• Methenamine hippurate is also a recommended alternative to prophylactic antibiotics in patients with intact bladder anatomy 1.
• Probiotics containing Lactobacillus may help maintain a healthy bacterial balance, although more research is needed to confirm their effectiveness 1. These strategies work by either reducing bacteria in the urinary tract or creating an environment less favorable for bacterial growth and attachment. It's essential to note that the most recent guidelines prioritize a multifaceted approach to preventing UTIs, including lifestyle modifications, dietary changes, and, when necessary, medical interventions 1.

From the FDA Drug Label

PRECAUTIONS Prescribing methenamine hippurate tablets in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria. Care should be taken to maintain an acid pH of the urine, especially when treating infections due to urea-splitting organisms such as Proteusand strains of Pseudomonas.

To prevent urinary tract infections (UTIs), maintaining an acid pH of the urine is important, especially when dealing with certain types of bacteria. Methenamine hippurate tablets can help with this by providing a prophylactic indication. However, it is crucial to use this medication only when necessary and under the guidance of a healthcare professional to avoid the development of drug-resistant bacteria.

• The medication should only be used to treat bacterial infections, not viral infections.
• Patients should be counseled to take the medication exactly as directed to ensure effectiveness and prevent resistance 2.

From the Research

Preventing Urinary Tract Infections (UTIs)

To prevent UTIs, several strategies can be employed, including:

• Increasing fluid intake to help flush out bacteria from the urinary tract 3
• Wiping from front to back to prevent bacteria from the anus entering the urethra 3
• Urinating after sexual activity to help flush out bacteria that may have entered the urethra 3
• Avoiding the use of spermicides, which can increase the risk of UTIs 4, 5
• Using probiotics to help maintain a healthy balance of bacteria in the urinary tract 4, 5, 6
• Taking cranberry supplements, which may help prevent bacteria from adhering to the bladder and urinary tract walls 4, 6, 7
• Using vitamin C supplements, which may help boost the immune system and prevent UTIs 6
• Considering topical estrogen therapy for postmenopausal women, which may help reduce the risk of UTIs 5, 3

Lifestyle Changes

Making lifestyle changes can also help prevent UTIs, including:

• Drinking plenty of water to stay hydrated and help flush out bacteria from the urinary tract
• Avoiding tight-fitting clothing and wearing cotton underwear to help keep the genital area dry and prevent bacterial growth
• Avoiding foods and drinks that can irritate the bladder, such as spicy or acidic foods
• Managing stress, which can help boost the immune system and prevent UTIs

Medical Interventions

In some cases, medical interventions may be necessary to prevent UTIs, including:

• Taking low-dose antibiotics to help prevent recurrent UTIs 5, 3
• Using a vaccine to help prevent UTIs, although this is still an area of research and development 4, 5
• Considering other non-antibiotic treatments, such as D-mannose, herbal medicine, or acupuncture, although the evidence for these treatments is still limited 7