The Effect of Short-term High-dose Treatment with Methenamine Hippurate of Urinary Infection in Geriatric Patients with Indwelling Catheters

Abstract

The u r i n e sediment of 12 g e r i a t r i c p a t i e n t s w i t h i n d w e l l i n g c a t h e t e r s was quant i f i e d by t h e glutaraldehyde-cytocentrifuge method p r i o r t o , d u r i n g and a f t e r a c l i n i c a l t r i a l of methenamine h i p p u r a t e (MH), 2 g x 3 d a i l y g i v e n f o r 34 days as t h e s o l e t h e r a p e u t i c agent f o r u r i n a r y t r a c t i n f e c t i o n . c o n c e n t r a t i o n i n t h e u r i n e of t h e s e p a t i e n t s w a s 100 c e l l s / p l ( Q , -Q3 5 0 -3 5 0 ) , i . e . t e n f o l d h i g h e r than t h e upper normal l i m i t s r e p o r t e d i n h e a l t h y probands.The median b a c t e r i u r i a i n t h e c o n t r o l p e r i o d was 1 2 x lo5 b a c t e r i a / m l u r i n e , i n t e r q u a r t i l e range 10-60 x 10 500 x 10 b a c t e r i a / m l . n o t prominent and could n o t be c o r r e l a t e d w i t h MH t r e a t m e n t , n o r w i t h c a t h e t e r changes. The r e p o r t e d o b s e r v a t i o n s s u g g e s t t h a t short-term high-dose t r e a t m e n t w i t h MH as s o l e t h e r a p e u t i c agent reduced p y r u r i a and b a c t e r i u r i a i n t h e group of p a t i e n t s s t u d i e d .

Preventing Catheter-Related Bacteriuria

“…77 Most studies of this agent have been small, nonrandomized trials in geriatric institutions. Using a before-and-after intervention design, oral methenamine hippurate therapy (2-6 g/d) was found to reduce the incidence of bacteriuria, 77,78 symptomatic UTI, 79 and pyuria. 80 One large, nonrandomized, comparative trial 81 found that patients receiving methenamine hippurate had significantly fewer courses of antibiotic drug therapy for symptomatic UTI and less frequent mechanical catheter complications.…”