Effectiveness of methenamine hippurate in preventing urinary tract infections: an updated systematic review, meta-analysis and trial sequential analysis of randomized controlled trials
Abstract
Introduction: Urinary Tract Infections (UTIs) are a significant health problem worldwide, especially among women. methenamine hippurate has been proposed as a preventive measure against recurrent UTIs. This updated systematic review and meta-analysis aimed to evaluate the effectiveness of methenamine hippurate in preventing UTIs, incorporating the latest research findings and employing trial sequential analysis to assess the robustness of the evidence.
Materials and methods: A systematic review was conducted across MEDLINE, Embase, Scopus, Cochrane, and Google Scholar up to March 2024 for randomized controlled trials comparing methenamine hippurate with placebo or antibiotic in adult women with a history of recurrent, confirmed UTIs. Key outcomes included symptomatic UTIs as primary outcome and positive urine culture, asymptomatic bacteriuria and adverse effects as secondary outcomes. It is important to state that asymptomatic UTIs with negative urine cultures were not adequately accounted for in the studies; therefore, this outcome was excluded from our meta-analysis. Additionally, adverse effects related to antibiotic resistance were not described in the studies, so only the adverse effects of the medications themselves were considered. The risk of bias was evaluated using the Cochrane Risk of Bias 2, and statistical analysis was conducted using RStudio software.
Results: We retrieved 5 articles, encompassing 216 patients in the methenamine group and 205 patients in the…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 216 participants or records.
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