Prophylactic methenamine hippurate or nitrofurantoin in patients with an indwelling urinary catheter.

作者：P. Nyrén, L Runeberg, ANJA A. I. KOSTIALA, O V Renkonen, Risto O. Roine · 发表于：PubMed · 年份：1981 · 被引用次数：34 · 研究领域：Urinary Tract Infections Management、Urinary Bladder and Prostate Research、Pelvic floor disorders treatments

One hundred and twenty three elderly patients without urinary tract infection who required an indwelling urinary catheter because of cerebrovascular disease were divided into three groups. One was given methenamine hippurate (MH), one nitrofurantoin (NF), while a control group received no prophylactic urinary tract disinfectant. Catheter complications, symptomatic urinary tract infections and the clinical course were recorded. At regular intervals bacteria were cultured from the urine, tests were made for antibody-coated bacteria (ACB) and routine laboratory investigations were performed. NF significantly delayed the appearance of ACB; however, it did not prevent their appearance if a catheter was used for more than two months, by which time ACB were present in most patients irrespective of treatment. MH had less effect on the bacteriological findings, although it significantly decreased the need for antibiotic courses given for treatment of symptomatic urinary tract infections. In both MH- and NF-groups there were fewer patients with mechanical catheter complications. Forty seven patients died, generally due to cerebrovascular disease, and 22 autopsies were performed. Gross inflammatory changes in the urinary tract were commonly found at autopsy in all groups if a catheter had been used for more than two weeks. A positive test for ACB considerably increased the probability of inflammatory changes in the kidneys, but because of the frequency of such changes after prolonged us...