Lee B B, Haran M J, Hunt L M, Simpson J M, Marial O, Rutkowski S B, Middleton J W, Kotsiou G, Tudehope M, Cameron I D
Spinal Medicine Department, Prince of Wales Hospital, Sydney, New South Wales, Australia.
Spinal Cord. 2007 Aug;45(8):542-50. doi: 10.1038/sj.sc.3101974. Epub 2006 Oct 17.
To determine whether Methenamine Hippurate (MH) or cranberry tablets prevent urinary tract infections (UTI) in people with neuropathic bladder following spinal cord injury (SCI).
Double-blind factorial-design randomized controlled trial (RCT) with 2 year recruitment period from November 2000 and 6 month follow-up.
In total, 543 eligible predominantly community dwelling patients were invited to participate in the study, of whom 305 (56%) agreed.
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.
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).
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.
确定马尿酸乌洛托品(MH)或蔓越莓片能否预防脊髓损伤(SCI)后神经性膀胱患者的尿路感染(UTI)。
双盲析因设计随机对照试验(RCT),招募期为2年(从2000年11月开始),随访期为6个月。
总共邀请了543名符合条件的主要居住在社区的患者参与研究,其中305名(56%)同意参加。
符合条件的参与者为患有神经源性膀胱且膀胱管理稳定的SCI患者。所有治疗方案在外观和味道上均无差异。使用的MH剂量为每日两次,每次1克。使用的蔓越莓剂量为每日两次,每次800毫克。主要结局指标是出现有症状UTI的时间。
多变量分析显示,与安慰剂相比,随机分配到MH组的患者无UTI期并无显著延长(风险比0.96,95%置信区间:0.68 - 1.35,P = 0.75)。与安慰剂相比,随机分配到蔓越莓组的患者无UTI期同样没有显著延长(风险比0.93,95%置信区间:0.67 - 1.31,P = 0.70)。
对于SCI后神经性膀胱患者,在常规治疗方案中添加MH或蔓越莓片对预防UTI并无益处。