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2.
Sci Total Environ ; 918: 170568, 2024 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-38309339

RESUMO

Among personal care products, quaternium-15 is prominently featured as a preservative in items such as shampoos, soaps, shaving products, and cosmetics. The widespread use of these products in people's daily routines contributes to quaternium-15 release into aquatic ecosystems. In this context, the primary aim of the study was to assess the physiological and cellular responses of the digestive gland and gills in Mytilus galloprovincialis to quaternium-15 exposure. Cell viability and the ability of digestive gland cells to regulate their volume were evaluated. Additionally, the expression of the genes involved in oxidative stress response was assessed to further substantiate the compound's harmful effects. Results indicated a significant decrease in both the viability of digestive gland cells and their RVD (regulatory volume decrease) capacity when exposed to a hypotonic solution. Furthermore, impairment of digestive gland cell function was corroborated by the modulation of oxidative stress-related gene expression, including SOD, Cat, as well as Hsp70 and CYP4Y1. Similar gene expression alterations were observed in the gills, reflecting impaired functionality in this vital organ as well. In summary, the outcomes of the study provide conclusive evidence of the toxicity of quaternium-15. This underscores the urgent need to further investigate the toxicological effects of this contaminant on aquatic ecosystems and emphasises the necessity of limiting the use of products containing quaternium-15.


Assuntos
Metenamina/análogos & derivados , Mytilus , Poluentes Químicos da Água , Humanos , Animais , Mytilus/fisiologia , Ecossistema , Estresse Oxidativo , Digestão , Poluentes Químicos da Água/análise , Brânquias/metabolismo , Biomarcadores/metabolismo
3.
J Fluoresc ; 34(1): 213-226, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37191828

RESUMO

Carbon quantum dots (CQDs) are a new type of fluorescent QDs that consists mainly of carbon atoms. In this research, CQDs were synthesized through harsh oxidizing conditions applied on carbon black and subsequent N-doping using hexamethylenetetramine (Hexamine) and polyethyleneimine (PEI). The synthesized CQDs were characterized using FTIR, AFM, UV-Visible spectroscopy, photoluminescence (PL) spectroscopy, and fluorescence imaging respectively. The AFM images showed that the dots are in the range of 2-8 nm. N-doping of the CQDs increased the PL intensity. The PL enhancement for the CQDs that were N-doped with PEI was higher compared to those N-doped with hexamine. The shift in PL by changing the excitation wavelength has been attributed to the nano-size of the CQDs, functional groups, defect traps, and quantum confinement effect. The in vitro fluorescence imaging revealed that N-doped CQDs can internalize into the cells and be used for fluorescent cell imaging.


Assuntos
Pontos Quânticos , Fuligem , Pontos Quânticos/química , Carbono/química , Metenamina
4.
Pharmacotherapy ; 44(2): 197-206, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37986168

RESUMO

Urinary tract infections (UTIs) commonly affect many patient populations. Recurrent UTIs (rUTIs) can be particularly problematic and lead to potential hospitalizations, multiple antibiotic courses, and have a potential negative impact on quality of life. To prevent UTIs, antibiotics are frequently used for prophylaxis; however, antibiotic prophylaxis has notable untoward consequences including but not limited to potential adverse effects and development of antibiotic resistance. Methenamine, an antiseptic agent initially available in 1967, has re-emerged as a potential option for UTI prophylaxis in various populations, including older adults and renal transplant recipients. The objective of this systematic review was to evaluate the clinical effectiveness and safety of methenamine for UTI prophylaxis. A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance was performed. A PubMed, Embase, and Cochrane library search was conducted to identify relevant English-language studies evaluating methenamine for UTI prophylaxis including randomized controlled trials, case-control studies, and meta-analyses through June 2023. Articles were excluded if the studies did not primarily describe or evaluate methenamine for UTI prophylaxis, were commentaries/viewpoints articles, point prevalence studies, review articles, studies that evaluated methenamine used with another agent, and any duplicate publications from searched databases. A total of 11 articles were identified for inclusion. This systematic review suggests methenamine generally appears to be an effective and well-tolerated antibiotic-sparing option for UTI prophylaxis. Furthermore, the pharmacology, dosage and formulation, warnings, precautions, and safety considerations of methenamine that provide potential clinical considerations regarding its use for UTI prophylaxis are described. Further studies are needed to evaluate the clinical utility of methenamine for UTI prophylaxis.


Assuntos
Metenamina , Infecções Urinárias , Humanos , Idoso , Metenamina/uso terapêutico , Qualidade de Vida , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/prevenção & controle , Infecções Urinárias/etiologia , Antibacterianos/efeitos adversos , Resultado do Tratamento , Antibioticoprofilaxia/efeitos adversos
6.
Med Mol Morphol ; 57(1): 23-34, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37823929

RESUMO

This study elucidated the etiology of C3 glomerulonephritis (C3GN) and non-C3GN with primary membranoproliferative glomerulonephritis (MPGN) using transmission electron microscopy (TEM) and periodic acid-methenamine silver stain (PAM-EM). Thirty-one primary MPGN cases were analyzed by TEM and PAM-EM to distinguish among MPGN I, MPGN II, MPGN III Burkholder subtype (MPGN IIIB), and Anders and Strife subtype (MPGN IIIA/S). Each case was also classified into C3GN or non-C3GN according to the standard C3GN definition using immunostaining. Four cases of MPGN II met C3 glomerulopathy; whereas, four cases of MPGN IIIB did not meet C3 glomerulopathy. Seven of 11 cases (64%) of MPGN I without GBM disruption and 7 of 12 cases (58%) of MPGN IIIA/S with GBM disruption met the non-C3GN criteria with significant immunoglobulins' deposition. Regardless of the C3GN or non-C3GN diagnosis, the deposits in primary MPGN I and MPGN IIIA/S exhibited ill-defined, amorphous, and foggy characteristics similar to those found in postinfectious GN but were different from immune complex (IC) deposits seen in MPGN IIIB. Not only C3GN but also non-C3GN was due to mechanisms other than IC deposition as found in postinfectious GN. Consequently, GBM disruption of MPGN IIIA/S was not due to IC deposition.


Assuntos
Glomerulonefrite Membranoproliferativa , Glomerulonefrite , Humanos , Metenamina , Ácido Periódico , Estudos Retrospectivos , Complemento C3/análise , Microscopia Eletrônica
7.
Eur Phys J E Soft Matter ; 46(12): 119, 2023 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-38051398

RESUMO

It is well established that deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) exhibit a reentrant condensation (RC) phase behavior in the presence of the trivalent hexamine cobalt(III) cations (Hac) which can be important for their packing and folding. A similar behavior can be observed for negatively charged globular proteins in the presence of trivalent metal cations, such as Y3+ or La3+. This phase behavior is mainly driven by charge inversion upon an increasing salt concentration for a fixed protein concentration (cp). However, as Hac exhibits structural differences compared to other multivalent metal cations, with six ammonia ligands (NH3) covalently bonded to the central cobalt atom, it is not clear that Hac can induce a similar phase behavior for proteins. In this work, we systematically investigate whether negatively charged globular proteins ß-lactoglobulin (BLG), bovine serum albumin (BSA), human serum albumin (HSA) and ovalbumin (OVA) feature Hac-induced RC. Effective protein-protein interactions were investigated by small-angle X-ray scattering. The reduced second virial coefficient (B2/B2HS) was obtained as a function of salt concentration. The virial coefficient analysis performed confirms the reentrant interaction (RI) behavior for BLG without actually inducing RC, given the insufficient strengths of the interactions for the latter to occur. In contrast, the strength of attraction for BSA, HSA and OVA are too weak to show RC. Model free analysis of the inverse intensity [Formula: see text] also supports this finding. Looking at different q-range by employing static (SLS) and dynamic light scattering experiments, the presence of RI behavior can be confirmed. The results are further discussed in view of metal cation binding sites in nucleic acids (DNA and RNA), where Hac induced RC phase behavior.


Assuntos
Cloretos , Cobalto , Humanos , Cloretos/química , Metenamina , Soroalbumina Bovina/química , Cátions/química , DNA , RNA , Soluções/química
8.
Rev Alerg Mex ; 70(4): 206, 2023 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-37933947

RESUMO

Background: Upper respiratory tract infections (URIs) are very common in the pediatric population. Most of these infections are mild, but due to their chronicity they affect quality of life (QoL), in addition to high costs for medical care. The use of bacterial extracts (BE) that stimulate general immunity can reduce its frequency and improve the QoL of the patient. Objective: Evaluate the effectiveness of a BE in the prevention of ARVI in children from 1 to 6 years of age. Methods: Children between the ages of 1 and 6 years, with a diagnosis of RAVI, were randomized into 3 different groups, with medical follow-up at 6 and 12 weeks after the start. The EB was administered with different doses to each group. An ANOVA test with a Tukey post hoc is used for multiple comparisons (maximum type I error of 0.05). Results: 33 children (12 girls) with a mean age of 3.11 years were included. The average frequency of RAVI prior to treatment was 2.2 events/month and 0.9 and 0.4 events/month at 6 and 12 weeks, respectively. The IVARS were reduced by 76.9% at 3 months of treatment. (Graph). No adverse effects were reported. Conclusions: BE is safe and effective in reducing the frequency of RAVI in children, in agreement with the literature. There is not enough published scientific evidence, but the BE seems to have an application in the prevention and treatment of RAVI. Sublingual administration is comfortable in this age group.


Antecedentes: Las infecciones de vías aéreas superiores (IVASR) son muy frecuentes en la población pediátrica. La mayoría de estas infecciones son leves, pero por la cronicidad afectan la calidad de vida (CdV), además de elevados costos por la atención médica. El uso de extractos bacterianos (EB) que estimulen la inmunidad general pueden reducir su frecuencia y mejorar la CdV del paciente. Objetivo: Evaluar la efectividad de un EB en la prevención de IVASR en niños de 1 a 6 años. Métodos: Se aleatorizaron niños entre 1 y 6 años, con diagnóstico IVASR en 3 grupos distintos, seguimiento médico a las 6 y 12 semanas tras el inicio. El EB se administró con dosis distintas a cada grupo. Se utiliza una prueba de ANOVA con un post hoc Tukey para comparaciones múltiples (error tipo I máximo de 0.05). Resultados: Se incluyeron 33 niños (12 niñas) con una media de edad de 3.11 años. La frecuencia de IVASR previo al tratamiento en promedio fue de 2.2 eventos/mes y de 0.9 y de 0.4 eventos/mes a las 6 y 12 semanas respectivamente. La IVARS se redujeron un 76.9% a los 3 meses de tratamiento. (Gráfica). No se reportaron efectos adversos. Conclusiones: El EB es seguro y efectivo en disminuir la frecuencia de IVASR en niños en concordancia con la literatura. No hay suficiente evidencia científica publicada pero el EB parece tener aplicación en la prevención y tratamiento de las IVASR. La administración sublingual es cómoda en este grupo etario.


Assuntos
Metenamina , Qualidade de Vida , Feminino , Humanos , Criança , Recém-Nascido , Lactente , Pré-Escolar , Administração Sublingual , Azul de Metileno , Estudos Retrospectivos
9.
Int Urogynecol J ; 34(12): 3051-3058, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37851092

RESUMO

INTRODUCTION AND HYPOTHESIS: Dysuria is a common symptom present in several urological and gynecological conditions. Management relies on the underlying disease but may require additional symptomatic treatment. This study evaluated the combination of methenamine 250 mg and methylthioninium chloride 20 mg in the treatment of dysuria versus phenazopyridine. METHODS: This was a multicenter, single-blind, randomized, superiority clinical trial, including individuals over 18 with dysuria and a score ≥ 5 points on the pre-treatment categorical scale for pain. The primary outcome was the proportion of participants presenting excellent clinical response within 24 h after treatment. Improvement up to 72 h, time to reach improvement, sustained healing, investigators' opinion, and safety were also evaluated. RESULTS: Three hundred and fifteen participants were evaluated. Demographic characteristics and symptoms of dysuria were comparable between groups at baseline. The difference in the excellent response rate between treatments within 24 h was 12.7% (95% CI 6.16, 19.21) for pain, 9.4% (95% CI 3.32, 15.39) for burning, and 12.7% (95% CI 6.37, 18.99) for burning on urination, all in favor of the test drug, which was also superior from 36 to 48 h. Treatments were similar concerning time to reach the absence of symptoms and in the percentage of participants with sustained healing after 72 h. CONCLUSIONS: The association of methenamine with methylthioninium is superior to phenazopyridine in the treatment of dysuria.


Assuntos
Disuria , Metenamina , Humanos , Disuria/tratamento farmacológico , Disuria/etiologia , Azul de Metileno , Dor , Fenazopiridina/uso terapêutico , Método Simples-Cego , Adulto
10.
Nat Commun ; 14(1): 5704, 2023 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-37709735

RESUMO

Catalytic asymmetric α-alkylation of carbonyl compounds represents a long-standing challenge in synthetic organic chemistry. Herein, we advance a dual biocatalytic platform for the efficient asymmetric alkylation of α-keto acids. First, guided by our recently obtained crystal structures, we develop SgvMVAV as a general biocatalyst for the enantioselective methylation, ethylation, allylation and propargylation of a range of α-keto acids with total turnover numbers (TTNs) up to 4,600. Second, we mine a family of bacterial HMTs from Pseudomonas species sharing less than 50% sequence identities with known HMTs and evaluated their activities in SAM regeneration. Our best performing HMT from P. aeruginosa, PaHMT, displays the highest SAM regeneration efficiencies (TTN up to 7,700) among HMTs characterized to date. Together, the synergistic use of SgvMVAV and PaHMT affords a fully biocatalytic protocol for asymmetric methylation featuring a record turnover efficiency, providing a solution to the notorious problem of asymmetric alkylation.


Assuntos
Engenharia , Metiltransferases , Metiltransferases/genética , Alquilação , Biocatálise , Cetoácidos , Metenamina , Pseudomonas aeruginosa/genética
12.
Curr Opin Urol ; 33(6): 488-496, 2023 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-37337660

RESUMO

PURPOSE OF REVIEW: Recurrent urinary tract infections (rUTIs) in women are prevalent and difficult to manage. The rise of antimicrobial resistance makes it prudent to re-investigate the role of nonantimicrobial agents in the prevention of RUTIs. We wanted to evaluate randomised controlled trials (RCTs) that employed methenamine hippurate as a therapy or prophylactic in adult women with rUTIs. RECENT FINDINGS: Relevant databases were searched for RCTs using Cochrane methodology and reporting items for systematic reviews and meta-analyses (PRISMA) checklist, comparing the efficacy of methenamine hippurate to either an antibiotic or a placebo for the prophylaxis of rUTI in women.Six trials involving 322 patients taking methenamine and 419 patients receiving antibiotics in total were evaluated. The duration of the trials ranged from 12-24 months. Studies reported that methenamine was effective in extending the mean period between symptomatic episodes of urinary tract infections (UTIs), keeping the patient symptom- and infection-free, and reducing the number of UTI episodes. The newer studies reported that methenamine reduced the incidence rates of recurrent UTIs and was not inferior to the antibiotic in this regard. SUMMARY: The outcomes of methenamine hippurate were found to be at par with the antibiotic prophylaxis. It might serve as a suitable alternative nonantibiotic prophylaxis for females with rUTIs.


Assuntos
Metenamina , Infecções Urinárias , Adulto , Feminino , Humanos , Metenamina/uso terapêutico , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologia , Infecções Urinárias/prevenção & controle , Hipuratos/uso terapêutico , Antibacterianos/uso terapêutico
13.
Histochem Cell Biol ; 160(2): 159-163, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37171628

RESUMO

Demonstration of glycogen can be done in different lesions and is considered diagnostically significant, mainly in some tumors. Glycogen staining is affected by the type of fixative, the temperature of fixation, and the staining technique.Grocott's methenamine (hexamine) silver technique quality was assessed after four different types of fixatives at two different temperatures [Bouin's solution, 10% neutral buffered formalin (NBF), 80% alcohol, and Rossman's solution at room temperature (RT) and 4 °C, for 24 h]. These variables were studied to optimize this technique for glycogen demonstration. Archived paraffin blocks were used in this study. They were prepared from one rabbit's liver, and 32 paraffin sections were prepared and stained with Grocott's methenamine (hexamine) silver technique. Eighty percent alcohol provided the highest staining quality scores at both RT and 4 °C in comparison with the other fixatives. We concluded that 80% alcohol at 4 °C seems to be the fixative of choice for glycogen with the Grocott's methenamine (hexamine) silver technique at the level of this study.


Assuntos
Glicogênio , Metenamina , Animais , Coelhos , Fixadores , Prata , Parafina , Coloração e Rotulagem , Fígado , Padrões de Referência
14.
Br J Nurs ; 32(9): S6-S12, 2023 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-37173081

RESUMO

The aim of this article is to share experience and learning of managing recurrent urinary tract infections (UTIs) within a specialist urology nurse-led team based at a district general hospital. It looks at current practice and supporting evidence for how to manage and treat recurrent UTIs in both male and female patients. Two case studies are presented to illustrate the management strategies and outcomes, demonstrating a planned approach that informs the design of a local management guideline to organise patients' care.


Assuntos
Infecções Urinárias , Urologia , Humanos , Masculino , Feminino , Metenamina , Papel do Profissional de Enfermagem , Hipuratos
15.
Curr Opin Urol ; 33(3): 187-192, 2023 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-36862100

RESUMO

PURPOSE OF REVIEW: There is a growing interest in nonantibiotic prevention strategies for recurrent urinary tract infections (rUTIs). Our objective is to provide a focused, pragmatic review of the latest evidence. RECENT FINDINGS: Vaginal estrogen is well tolerated and effective for preventing rUTI in postmenopausal women. Cranberry supplements at sufficient doses are effective in preventing uncomplicated rUTI. Methenamine, d -mannose, and increased hydration all have evidence to support their use, although the evidence is of somewhat variable quality. SUMMARY: There is sufficient evidence to recommend vaginal estrogen and cranberry as first-line rUTI prevention strategies, particularly in postmenopausal women. Prevention strategies can be used in series or in tandem, based on patient preference and tolerance for side effects, to create effective nonantibiotic rUTI prevention strategies.


Assuntos
Terapias Complementares , Infecções Urinárias , Feminino , Humanos , Infecções Urinárias/tratamento farmacológico , Metenamina/uso terapêutico , Estrogênios/uso terapêutico , Assistência Centrada no Paciente , Recidiva
16.
Ecotoxicol Environ Saf ; 254: 114698, 2023 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-36871352

RESUMO

In this study, we synthesized and employed the amine impregnated activated carbon as an efficacious adsorbent for uptaking gasoline vapor. For this regard, anthracite as activated carbon source and hexamethylenetetramine (HMTA) as amine were selected and utilized. Physiochemical characterization of made sorbents were evaluated and investigated using SEM, FESEM, BET, FTIR, XRD, zeta potential, and elemental analysis. The synthesized sorbents provided an excellent textural features as compared with the literature and other activated carbon based sorbents and impregnated with amine. Our findings also suggested that in addition to high surface area (up to 2150 m2 / g), the micro- meso pores created (Vmeso / V micro = 0.79 Cm 3 / g) surface chemistry may significantly affect the gasoline sorption capacity, which here the role of mesoporous is further highlighted. V meso for amine impregnated sample and free activated carbon was 0.89 and 0.31 Cm 3 / g, respectively. According to the results, the prepared sorbents have a potential capability in uptaking gasoline vapor and with line this, we report a high sorption capacity of 572.56 mg / g. After, four cycles used the sorbent had a high durability and about 99.11% of the initial uptake was maintained. Taking together the synthesized adsorbents as an activated carbon provided an excellent and unique features and enhanced gasoline uptake, therefore its applicability in uptaking gasoline vapor can be substantially considered.


Assuntos
Gasolina , Metenamina , Carvão Vegetal/química , Carvão Mineral , Adsorção , Gases , Aminas
17.
Molecules ; 28(2)2023 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-36677950

RESUMO

The paper presents the preparation of new ionic liquids based on hexamethylenetetramine with bis(trifluoromethanesulfonyl)imide and dicyanamide anion, which were characterized in detail in terms of their purity (Ion Chromatography) and thermal properties (Differential Scanning Calorimetry), as well as stability. The obtained substances were used to develop curing systems with ethylene glycol, which were successfully tested for their application with bisphenol A diglycidyl ether molecule. In addition, the curing process and its relationship to the structure of the ionic liquid are characterized in detail. The research showed that hexamethylenetetramine-based new ionic liquids can be successfully designed using well-known and simple synthetic methods-the Delepine reaction. Moreover, attention was paid to their stability, related limitations, and the application of hexamethylenetetramine-based ionic liquids in epoxy-curing systems.


Assuntos
Líquidos Iônicos , Líquidos Iônicos/química , Metenamina , Etilenoglicol , Compostos de Epóxi/química
18.
BMJ ; 380: 72, 2023 01 17.
Artigo em Inglês | MEDLINE | ID: mdl-36649970

RESUMO

The studyHarding C, Mossop H, Homer T, et al. Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women: multicentre, open label, randomised, non-inferiority trial. BMJ 2022;376:e068229.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/methenamine-as-good-as-antibiotics-preventing-urinary-tract-infections/.


Assuntos
Metenamina , Infecções Urinárias , Feminino , Humanos , Antibacterianos/uso terapêutico , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/prevenção & controle
19.
Int J Biol Macromol ; 228: 754-772, 2023 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-36563810

RESUMO

In this study, a novel eco-friendly sorbent, hexamethylenetetramine (HMTA) functionalized calcium alginate (AG) immobilized graphene oxide (GO) composite (AG-GO-HMTA) and hexamethylenetetramine functionalized calcium alginate composite (AG-HMTA) were prepared. Adsorption factors including pH impact, contact time, initial dye concentration, dosage, selectivity and reusability on methylene blue (MB) removal from water were investigated. The prepared sorbents were characterized using structural (e.g. XRD, FT-IR, EDAX), thermal (e.g. TGA, DTG), and morphological (e.g. SEM, BET) analysis techniques. The equilibrium adsorption data was described by the Langmuir and Freundlich isotherms, and the adsorption kinetic and thermodynamic parameters were investigated. The field studies and regeneration of the beads were investigated. AG-GO HMTA displays a well-defined porous structure and this desired morphology arising from high quality dispersion of HMTA within the AG-GO matrix. The highest adsorption capacities were observed at pH âˆ¼ 5, meanwhile the adsorption of MB dye molecules, positively charged, onto the beads became faster due to strong electrostatic interactions. When the value of dosage is 0.01 g, the equilibrium concentration (mg/g) are maximum at 103, 110, 164, 168 mg/g for AG, AG-GO, AG-HMTA and AG-GO-HMTA, respectively. The present work shows that pseudo first order could describe the MB adsorption onto AG while it couldn't describe the MB adsorption onto the functionalized sorbents due to the hybrid materials complicity.


Assuntos
Grafite , Nanocompostos , Poluentes Químicos da Água , Metenamina , Alginatos/química , Espectroscopia de Infravermelho com Transformada de Fourier , Água , Grafite/química , Adsorção , Poluentes Químicos da Água/química , Concentração de Íons de Hidrogênio , Cinética , Azul de Metileno/química
20.
Scand J Prim Health Care ; 40(3): 331-338, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36369890

RESUMO

BACKGROUND: Urinary tract infection (UTI) is the most common bacterial infection in women. In Norwegian general practice, methenamine has been prescribed for many years as long-term prevention and accounted for 20% of the total antibiotic prescribing in 2015, as measured in defined daily dosages (DDDs). The efficacy of methenamine is unknown. If shown to be effective, this drug may become an important preventive against UTI. OBJECTIVE: To examine whether methenamine is preventive against recurrent UTI in women. DESIGN: Data for all antibiotics used for UTIs dispensed from all pharmacies from 2005 to 2015 were collected from the Norwegian prescription database (NorPD). SUBJECTS: Women aged ≥ 40 years with recurrent UTI, defined as ≥3 courses of UTI antibiotic/year, were included. MAIN OUTCOME MEASURES: Patients using methenamine (cases) and those not using methenamine (controls) were compared. The numbers of UTI prescriptions during the 2 years before and after inclusion were analysed. Results: The yearly prevalence for recurrent UTI was 2.4% in women ≥ 40 years. The change in antibiotic use from 2 years before to 2 years after inclusion in the study differed significantly between groups: 44.6 and 34.9% reductions in the number of antibiotic prescriptions for UTI in the methenamine and control groups, respectively. The decrease in UTI antibiotic prescriptions (58.9%) was greater in patients with a higher consumption of antibiotics before starting methenamine. CONCLUSIONS: Methenamine seems to be effective against recurrent UTI over the time span studied. The effect seems to be greater in patients with the highest number of recurrent UTIs. Key pointsMethenamine has been used for many years for prevention of recurrent UTI, but no studies have demonstrated a significant preventive effect of long time use.This study shows that methenamine seems to be effective for prevention in patients having recurrent UTI over 2 years or more.The effect seems to be larger in patients with a high number of UTIs over 2 years.


Assuntos
Medicina Geral , Infecções Urinárias , Humanos , Feminino , Metenamina/uso terapêutico , Estudos de Casos e Controles , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/prevenção & controle , Antibacterianos/uso terapêutico
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