Posted ,
Reading 2 mins.
in collaboration with
Dr Odile Bagot (Gynecologist-obstetrician)
Urinary tract infection is a very common reason for consultation in gynecology practices. During repeat episodes, an antibiotic can be prescribed for prevention depending on the situation. However, another therapeutic alternative now seems possible, even essential, due to the increase in bacterial resistance.
The role of the prophylactic antibiotic
Cystitis is a urinary tract infection located in the bladder. Quite common in women, they are very often caused by the bacteria Escherichia Coli. Although the UTI is mild, it can come back repeatedly.
When a woman has had at least 2 diagnosed cystitis during the last 6 months or 3 urinary tract infections during the last 12 months, we speak of recurrent cystitis or recurrent cystitis. According to doctor Odile Bagot, gynecologist, the treatment of urinary tract infections in postmenopausal women is based on the local intake of estrogens.
To prevent these infectious episodes, one of the treatments prescribed is prophylactic antibiotic therapy. The antibiotic should be taken 2 hours before or after sexual intercourse, if this is a contributing factor. Otherwise, it is administered continuously and requires medical monitoring of the patient at the rate of two consultations per year with a gynecologist.
Find an alternative to antibiotics
Nevertheless, the health authorities of the United Kingdom emphasize the major issues concerning this preventive care.
- On the one hand, this inflammation represents an annual cost of several billion;
- On the other hand, bacteria are increasingly resistant to antibiotic treatments, especially when taken over the long term.
This is why British researchers stress the urgent need to develop more effective non-antibiotic drug solutions to prevent recurrent urinary tract infections.
Reduce antimicrobial use by 15% by 2024
As a reminder, an antibiotic is a drug that prevents bacterial multiplication or destroys bacteria within an infected organism. To achieve this objective and reduce the impact of this problem deemed to be a public health problem, scientists are counting on a preventive treatment which is therefore not an antibiotic: methenamine hippurate. It is a bactericide whose role is to alter the proteins of bacteria.
From 2016 to 2018, women over the age of 18 with recurrent urinary tract infections and on prophylactic antibiotics were recruited and followed up at 8 urology and urogynecology centers in the UK. Of the 205 participants, 103 received hippurate and 102 the antibiotic. Preliminary results demonstrate that hippurate does not have inferior efficacy compared to the prophylactic antimicrobial. Besides, one of the other advantages of methenamine hippurate is that it has few side effects. It would therefore be better tolerated by patients.
For now, in France, “methenamine hippurate has not yet been included in the HAS recommendations [Haute Autorité de Santé]” emphasizes Dr. Bagot. It is therefore too early to consider this therapeutic alternative.
Consult a GP online
Cystitis: means of prevention
Nevertheless, it would seem that drug prophylaxis is not always the most appropriate method for treating recurrent cystitis. To avoid recurrences, Doctor Odile Bagot, advises to hydrate sufficiently by drinking at least 1.5 liters of water per day in order to evacuate bacteria from the bladder. She also recommends:
- not to refrain from urinating;
- avoid douching and the use of perfumed intimate hygiene products or spermicide;
- to urinate after any sexual intercourse;
- not to be tight in underwear;
- to wipe back and forth;
- to avoid the use of panty liners.