Spinal-injured neuropathic bladder antisepsis (SINBA) trial.

Abstract

OBJECTIVE:

To determine whether Methenamine Hippurate (MH) or cranberry tablets prevent urinary tract infections (UTI) in people with neuropathic bladder following spinal cord injury (SCI).

STUDY DESIGN:

Double-blind factorial-design randomized controlled trial (RCT) with 2 year recruitment period from November 2000 and 6 month follow-up.

SETTING:

In total, 543 eligible predominantly community dwelling patients were invited to participate in the study, of whom 305 (56%) agreed.

METHODS:

Eligible participants were people with SCI with neurogenic bladder and stable bladder management. All regimens were indistinguishable in appearance and taste. The dose of MH used was 1 g twice-daily. The dose of cranberry used was 800 mg twice-daily. The main outcome measure was the time to occurrence of a symptomatic UTI.

RESULTS:

Multivariate analysis revealed that patients randomized to MH did not have a significantly longer UTI-free period compared to placebo (HR 0.96, 95% CI: 0.68-1.35, P=0.75). Patients randomized to cranberry likewise did not have significantly longer UTI-free period compared to placebo (HR 0.93, 95% CI: 0.67-1.31, P=0.70).

CONCLUSION:

There is no benefit in the prevention of UTI from the addition of MH or cranberry tablets to the usual regimen of patients with neuropathic bladder following SCI.

• Authors: B B Lee, M J Haran, L M Hunt, J M Simpson, O Marial, S B Rutkowski, J W Middleton, G Kotsiou, M Tudehope, I D Cameron
• Journal: Spinal cord (Spinal Cord) Vol. 45 Issue 8 Pg. 542-50 (Aug 2007) ISSN: 1362-4393 [Print] England
• PMID: 17043681 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Infective Agents, Urinary
• Hippurates
• Plant Extracts
• Tablets
• Methenamine
• methenamine hippurate

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Anti-Infective Agents, Urinary (therapeutic use)
• Double-Blind Method
• Female
• Hippurates (therapeutic use)
• Humans
• Male
• Methenamine (analogs & derivatives, therapeutic use)
• Middle Aged
• Multivariate Analysis
• Phytotherapy
• Plant Extracts (therapeutic use)
• Spinal Cord Injuries (complications)
• Tablets
• Treatment Failure
• Urinary Bladder, Neurogenic (drug therapy, etiology)
• Urinary Tract Infections (prevention & control)
• Vaccinium macrocarpon (chemistry)