Recurrent urinary tract infections can be difficult to manage. Recently, I have had several patients with recurrent UTIs who have not done well with being on prophylactic antibiotics (or antibiotics used in a daily low dose to prevent UTIs). In several cases, the chronic use of antibiotics to treat and prevent UTIs has caused C.Diff colitis. Some patients can also experience side effects from using the antibiotics, such as behavioral changes. Most commonly, chronic use of antibiotics leads to resistant bacteria, making it harder to treat a UTI or another bacterial infection with oral antibiotics. Additionally, many families are weary about putting their child on an antibiotic for an extended period of time.
What is Methenamine and how does it work?
Methenamine Hippurate is an alternative to the typical antibiotic to prevent urinary tract infections. It is an antibacterial medication, not an antibiotic. Instead of killing the bacteria, Methenamine Hippurate helps to acidify the urine and is converted into formaldehyde which helps to suppress the growth of bacteria. It was commonly used in the past for recurrent UTIs at a time when there were not as many options in the antibiotic arena. It went out of favor because of the increasing availability of antibiotics used to kill bacteria, which are very effective. However, because of the resistance of bacteria and side effects from antibiotics, Methenamine can be a great alternative or second or third line option in tackling recurrent UTIs.
It is available with a prescription and is made in capsule formulation. I’ve had patients open the capsule and put the granules into applesauce or yogurt to help with ingesting the medication. Ask your medical provider who is helping manage the UTIs about Methenamine. Most urologists or providers in urology, should be comfortable about working with you to figure out what works best to treat recurrent UTIs. Sometimes just using an antibiotic for prophylaxis is not always the answer.