From the Guidelines
To prevent UTIs, I strongly recommend using methenamine hippurate, 1 g twice daily, as an alternative to prophylactic antibiotics in patients with intact bladder anatomy, as it has been shown to be noninferior to antibiotics in preventing recurrent UTIs 1.
Preventative Measures
When considering preventative measures for UTIs, it's essential to weigh the benefits and risks of each option.
- Maintaining good hygiene and urinating after sexual activity can help reduce the risk of UTIs.
- Staying well-hydrated by drinking an additional 1.5L of water per day may also decrease the incidence of UTIs, especially in healthy women 1.
- Cranberry products containing proanthocyanidin levels of 36 mg may reduce recurrent UTIs in women, children, and individuals susceptible to UTIs, although the evidence is not strong for other populations 1.
- Vaginal estrogen creams can benefit postmenopausal women by maintaining healthy vaginal flora 1.
Medical Interventions
For those with recurrent UTIs, defined as 2+ infections in 6 months or 3+ in a year, a doctor may prescribe prophylactic antibiotics like nitrofurantoin or trimethoprim-sulfamethoxazole to be taken daily or after sexual activity 1.
- Methenamine hippurate is a recommended alternative to prophylactic antibiotics, with a dosage of 1 g twice daily, due to its ability to release formaldehyde in acidic urine, resulting in bacteriostasis 1. It's crucial to consult a healthcare provider for proper diagnosis and treatment if UTI symptoms occur, rather than relying solely on preventative measures.
From the FDA Drug Label
Methenamine Hippurate Tablets are indicated for prophylactic or suppressive treatment of frequently recurring urinary tract infections when long-term therapy is considered necessary. There is a UTI preventative medication available, which is methenamine hippurate tablets, used for prophylactic or suppressive treatment of frequently recurring urinary tract infections, as stated in the drug label 2.
- The medication should only be used after eradication of the infection by other appropriate antimicrobial agents.
- Long-term therapy is considered necessary for this treatment.
From the Research
UTI Spray Preventative Med
- There are various strategies for preventing recurrent urinary tract infections (UTIs), including antibiotics, functional foods, vaccines, probiotics, and miscellaneous approaches such as avoidance of spermicides and maintenance of good hygiene 3.
- Methenamine hippurate has been studied as an alternative to low-dose antibiotics for the prevention of recurrent UTIs, with some studies showing similar rates of recurrence and adverse effects to trimethoprim 4, 5.
- A systematic review and meta-analysis found that methenamine hippurate may have a non-statistically significant trend of benefit versus antibiotics or placebo in preventing UTIs, but further research is needed to confirm its effectiveness 5.
- Some studies have investigated the use of combination therapies, such as trimethoprim and methenamine hippurate, in the treatment of acute UTIs, with varying results 6.
- Lifestyle changes, such as increasing fluid intake, wiping from front to back, and urinating after sexual activity, are commonly used by women to prevent UTIs, and may be recommended by healthcare providers 7.
- Other preventative measures, such as cranberry extract and low-dose prophylactic antibiotics, may also be used by women with recurrent UTIs, although their effectiveness is not universally established 3, 7.