Recurrent urinary tract infections: Evaluation of the prophylactic efficacy of urinary antiseptics methenamine and methylthioninium chloride

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dc.contributor.authorGeller, Mauro
dc.contributor.authorGama, Carlos Romualdo Barboza [UNESP]
dc.contributor.authorGuimarães, Oscar Roberto
dc.contributor.authorVarella, Rafael Brandão
dc.contributor.authorOliveira, Lisa
dc.contributor.authorDa Fonseca, Adenilson de Souza
dc.contributor.authorDe Paoli, Severo
dc.contributor.authorDe Paoli, Flavia
dc.contributor.institutionUNIFESO
dc.contributor.institutionInstituto PGM Carlos Chagas
dc.contributor.institutionNYU
dc.contributor.institutionHarvard University
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionColégio Brasileiro de Cirurgiões
dc.contributor.institutionUniversidade Federal do Rio de Janeiro (UFRJ)
dc.contributor.institutionUFF
dc.date.accessioned2014-05-27T11:23:41Z
dc.date.available2014-05-27T11:23:41Z
dc.date.issued2008-11-01
dc.description.abstractIntroduction: Urinary tract infection (UTI) is a very common condition in clinical practice, affecting an estimated 50% of all adult women during a lifetime. The most common causative agent is E. coli; UTI may also be caused by S. saprophyticus, Enterobacteria (Klebsiella sp and Serratia sp.), Enterococcus sp., and P aeruginosa. Recurrent UTIs occur at least twice per semester or three times a year. Prophylactic measures to prevent recurrent UTIs include changes in contraception methods, cranberry products, increased fluid intake, urination after intercourse, vaginal estrogen therapy for post-menopausal women, antibiotics, and urinary tract antiseptic agents. Objectives: To evaluate the use of a combination of methenamine and methyl-thioninium chloride in the prophylaxis of recurrent uncomplicated lower UTIs, with respect to: • Signs and symptoms of UTI • Etiologic agent(s) • Recurrence rates • Need for antibiotic therapy in case of recurrence • Incidence of adverse events associated with the treatment, including any reported alterations of laboratory tests Materials & methods: A descriptive, analytic, restrospective study was performed at Hospital Universitário Constantino Otaviano - UNIFESO. Medical charts from patients presenting recurrent uncomplicated lower UTI attended from 2001-present were analyzed, including the following information: Demographic data (age, gender, weight, ethnicity, living conditions): medical history/signs and symptoms of UTI; identification of treatment and dosing regimens; treatment duration; recurrence rates and need for antibiotic therapy in case of recurrence; other medications prescribed; and records of adverse events. Results: E. coli was identified as etiologic agent in 80% of the patients. Following antibiotic therapy, all patients received prophylactic treatment with the combination of methenamine and methylthioninium chloride. Treatment duration ranged from three to six months. Adverse events were observed in 13/60 patients (21.7%). At the end of the respective treatment periods, a statistically significant (p<0.0001) number of patients showed no UTI recurrence. Conclusion: Based on the results from the collected data, we conclude that an orally administered combination of methenamine and methylthioninium chloride is safe and effective in the prophylactic treatment of recurrent uncomplicated lower urinary tract infection. © Copyright Morelra Jr. Editora.en
dc.description.affiliationMicrobiologia e Imunologia UNIFESO
dc.description.affiliationImunologia Clínica Instituto PGM Carlos Chagas
dc.description.affiliationImunogenética NYU
dc.description.affiliationHarvard University
dc.description.affiliationGinecologia UNIFESO
dc.description.affiliationGinecologia UNESP
dc.description.affiliationColégio Brasileiro de Cirurgiões
dc.description.affiliationMicrobiologia e Imunologia UFRJ
dc.description.affiliationMedicina UNIFESO
dc.description.affiliationDIP/UFRJ
dc.description.affiliationFisiologia UNIFESO
dc.description.affiliationMorfologia UNIFESO UFF
dc.description.affiliationFarmacologia UNIFESO
dc.description.affiliationUnespGinecologia UNESP
dc.format.extent367-371
dc.identifierhttp://www.moreirajr.com.br/revistas.asp?id_materia=3924&fase=imprime
dc.identifier.citationRevista Brasileira de Medicina, v. 65, n. 11, p. 367-371, 2008.
dc.identifier.issn0034-7264
dc.identifier.scopus2-s2.0-57349182540
dc.identifier.urihttp://hdl.handle.net/11449/70625
dc.language.isoeng
dc.relation.ispartofRevista Brasileira de Medicina
dc.relation.ispartofsjr0,101
dc.rights.accessRightsAcesso restrito
dc.sourceScopus
dc.subjectMethenamine
dc.subjectMethylthioninium chloride
dc.subjectProphylaxis
dc.subjectRecurrent urinary tract infection
dc.subjectantiinfective agent
dc.subjectmethenamine
dc.subjectmethylthioninium chloride
dc.subjectunclassified drug
dc.subjectadult
dc.subjectantibiotic therapy
dc.subjectcontrolled study
dc.subjectdemography
dc.subjectdiarrhea
dc.subjectdrug dose regimen
dc.subjectdyspepsia
dc.subjectepigastric pain
dc.subjectEscherichia coli
dc.subjectfemale
dc.subjectheadache
dc.subjecthuman
dc.subjectlaboratory test
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectnausea
dc.subjectrash
dc.subjectrecurrent disease
dc.subjectretrospective study
dc.subjecttreatment duration
dc.subjecturinary tract infection
dc.titleRecurrent urinary tract infections: Evaluation of the prophylactic efficacy of urinary antiseptics methenamine and methylthioninium chlorideen
dc.typeArtigo
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt

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