Does methenamine hippurate decrease urinary tract symptoms in community adult women: a systematic review and meta-analysis
Review (6 studies; n=557) found a non-significant trend of benefit of methenamine hippurate vs antibiotics over 12 months (RR 0.65, 95%CI 0.4-1.07, I2=49%); vs controls over 6/12 months (0.56; 0.13-2.35; 93%) and vs any antibiotic for abacteruria (0.80; 0.62-1.03; 23%).
Source:
British Journal of General Practice
SPS commentary:
Review concludes that there is insufficient data to support the efficacy of methamine hippurate for urinary tract infections.
The BNF considers methenamine hippurate less suitable for prescribing, noting that it should not generally be used because it requires an acidic urine for its antimicrobial activity and it is ineffective for upper urinary-tract infections. It may have a role in the prophylaxis and treatment of chronic or recurrent uncomplicated lower urinary-tract infections.