Evidence map›Paper›PMID 35264408›Full record

Trial reportBMJ (Clinical research ed.)2022

Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women: multicentre, open label, randomised, non-inferiority trial.

Chris Harding, Helen Mossop, Tara Homer, Thomas Chadwick, William King, Sonya Carnell, Jan Lecouturier, Alaa Abouhajar, Luke Vale, Gillian Watson and 11 more

Registry-linked trialOpen access · hybridAbstract readEquivalence TrialMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07698041 (Developing and Validating Two New Patient-Reported Outcome Measures of Recurrent Urinary Tract Infection Symptoms), which is not on this map. Cited by 61 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed, 1 pooled it
13.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07698041 not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Developing and Validating Two New Patient-Reported Outcome Measures of Recurrent Urinary Tract Infection Symptoms: A Symptoms Diary and Adapted Measure for Older Adults

TypeobservationalSponsorKatherine FinlayRan2026 to 2027Enrolled200ConditionsUrology, Urological Diseases, Patient Satisfaction, Pain, ChronicArmsNon-interventional Patient Reported Outcome Measure Development (RUTISS-Diary), Non-interventional Patient Reported Outcome Measure Development (RUTISS-65)
3 · Its place in the literature

Who cites it

61 citing papers in PubMed, 1 synthesis or guideline pooled it, 95 citations in OpenAlex.

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1 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors at 8 institutions in 1 country.

Chris HardingDepartment of Urology, Freeman Hospital, Newcastle upon Tyne, UK.ORCID 0000-0002-9407-382X
Helen MossopPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Tara HomerPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Thomas ChadwickPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
William KingPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Sonya CarnellNewcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK.
Jan LecouturierPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Alaa AbouhajarNewcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK.
Luke ValePopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Gillian WatsonNewcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK.
Rebecca ForbesNewcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK.
Stephanie CurrerNewcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK.
Robert PickardTranslational and Clinical Research Institute, William Leech Building, The Medical School, Newcastle upon Tyne, UK.
Ian EardleyLeeds Teaching Hospital Trust, Leeds, UK.
Ian PearceManchester University Hospitals NHS Foundation Trust, Manchester, UK.
Nikesh ThiruchelvamAddenbrooke's Hospital, Cambridge, UK.
Karen GuerreroQueen Elizabeth University Hospital, Glasgow, UK.
Katherine WaltonDepartment of Microbiology, Freeman Hospital, Newcastle upon Tyne, UK.
Zahid HussainRoyal Oldham Hospital, Oldham, UK.
Henry LazarowiczLiverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
Ased AliPinderfields Hospital, Wakefield, UK.
Newcastle University · GBFreeman Hospital · GBAddenbrooke's Hospital · GBLeeds Teaching Hospitals NHS Trust · GBPinderfields Hospital · GBQueen Elizabeth University Hospital · GBRoyal Oldham Hospital · GBUniversity of Liverpool · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo test and compare the efficacy of methenamine hippurate for prevention of recurrent urinary tract infections with the current standard prophylaxis of daily low dose antibiotics.

designMulticentre, open label, randomised, non-inferiority trial.

settingEight centres in the UK, recruiting from June 2016 to June 2018.

participantsWomen aged ≥18 years with recurrent urinary tract infections, requiring prophylactic treatment.

interventionsRandom assignment (1:1, using permuted blocks of variable length via a web based system) to receive antibiotic prophylaxis or methenamine hippurate for 12 months. Treatment allocation was not masked and crossover between arms was allowed.

main outcome measureAbsolute difference in incidence of symptomatic, antibiotic treated, urinary tract infections during treatment. A patient and public involvement group predefined the non-inferiority margin as one episode of urinary tract infection per person year. Analyses performed in a modified intention-to-treat population comprised all participants observed for at least six months.

resultsParticipants were randomly assigned to antibiotic prophylaxis (n=120) or methenamine hippurate (n=120). The modified intention-to-treat analysis comprised 205 (85%) participants (antibiotics, n=102 (85%); methenamine hippurate, n=103 (86%)). Incidence of antibiotic treated urinary tract infections during the 12 month treatment period was 0.89 episodes per person year (95% confidence interval 0.65 to 1.12) in the antibiotics group and 1.38 (1.05 to 1.72) in the methenamine hippurate group, with an absolute difference of 0.49 (90% confidence interval 0.15 to 0.84) confirming non-inferiority. Adverse reactions were reported by 34/142 (24%) in the antibiotic group and 35/127 (28%) in the methenamine group and most reactions were mild.

conclusionNon-antibiotic prophylactic treatment with methenamine hippurate might be appropriate for women with a history of recurrent episodes of urinary tract infections, informed by patient preferences and antibiotic stewardship initiatives, given the demonstration of non-inferiority to daily antibiotic prophylaxis seen in this trial.

trial registrationISRCTN70219762.

Indexed as

Antibiotic ProphylaxisAdolescentAdultAnti-Bacterial AgentsFemaleHippuratesHumansMethenamineMiddle AgedRecurrenceTreatment OutcomeUrinary Tract InfectionsYoung AdultAnti-Bacterial AgentsHippuratesMethenaminemethenamine hippurate

Identifiers

PMID35264408
PMCPMC8905684
OpenAlexW4220810008

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.