Extended High-Dose Antibiotics Plus Methenamine Hippurate Versus Standard Low-Dose Antibiotics or Methenamine Hippurate for Chronic Urinary Tract Infection in Women

What this Trial Is About

Chronic Urinary Tract Infection UTI causes daily, persistent symptoms unlike recurrent UTIs that come and go. Current treatments within the NHS often use low-dose antibiotics or methenamine hippurate but may not fully relieve symptoms. This trial investigates whether longer courses of higher-dose antibiotics combined with methenamine hippurate can better reduce infection and symptoms in females with chronic UTI. Participants will be randomly assigned to one of two groups. One group receives a higher-dose antibiotic cefalexin, nitrofurantoin, or trimethoprim combined with methenamine hippurate twice daily for 12 weeks. The other group receives a low-dose prophylactic antibiotic amoxicillin, cefalexin, nitrofurantoin, or trimethoprim or methenamine hippurate alone for 12 weeks. Treatment choices are tailored by clinicians based on individual needs. During the 12-week treatment, participants attend clinic visits every 4 weeks for assessments. They complete questionnaires and provide blood, urine, and perineal swab samples. Researchers measure changes in urinary white blood cell counts and monitor symptoms, quality of life, medication satisfaction, treatment adherence, and safety through various clinical and laboratory tests throughout the study.

A Clinical Trial of Extended (High) Treatment Dose Antibiotics in Combination With Methenamine Hippurate Compared to the Standard of Care (Either Prophylactic (Low) Dose Antibiotic Treatment or Methenamine Hippurate) in Females With Chronic Urinary Tract Infection