Thousands of people suffering from agonizing and recurrent bladder infections are missing out on a simple antiseptic treatment that removes bacteria from the urine.
The methanamine-purified pill avoids increasingly common problems with traditional antibiotic treatments that can damage the liver and kidneys or even become useless in the face of antibiotic-resistant bacteria.
Also known as the Hiprex brand, studies show that it can be just as effective when used to treat persistent infections as antibiotics. However, experts warn that too few patients benefit from it, due to outdated prescribing guidelines and that many doctors may not even know it exists as an alternative.
Every year more than one million Britons, 80% of them women, develop a bladder or urinary tract infection (UTI). Symptoms include burning pain when urinating, frequent urination, and a sense of need for the toilet even when the bladder is empty.
Older people are more at risk as their bladder works less with age and may not empty completely when they go to the toilet, so bacteria remain in the urinary tract.
Thousands of people suffering from agonizing and recurrent bladder infections are missing out on a simple antiseptic treatment that removes bacteria from the urine. The methanamine-purified pill avoids increasingly common problems with traditional antibiotic treatments that can damage the liver and kidneys or even become useless in the face of antibiotic-resistant bacteria.
Postmenopausal women are also more prone, as the female sex hormone estrogen helps maintain lower urinary tract tissues and, as their levels drop, they become more vulnerable to infections.
One in ten women over the age of 65, and almost three in ten women over the age of 85, will have had an ITU in the last year. In elderly patients they can cause a condition similar to dementia called delirium, and there is also a risk of sepsis, which causes about 10,000 deaths a year.
For the most part, a short course of antibiotics eliminates the infection in a matter of days, but as many as 1.6 million people in the UK suffer from chronic urinary tract infections, classified as three or more infections a year.
The first-line treatment for these patients is to stay permanently with low-dose antibiotics, but about one-fifth experience side effects that can damage the liver and kidneys. Antibiotics are also becoming more ineffective as bacteria become resistant to drugs.
“Hiprex has changed my life,” says Helen Rawnsley (above), 27, of Birmingham. A private urologist prescribed the drug in October 2020 when, after suffering from repeated urinary tract infections for three months, the antibiotics stopped working.
Hiprex offers an alternative option for these patients. The body breaks down the drug, releasing ammonia and formaldehyde that inhibit bacterial growth, and experts believe that the pathogens that cause UTIs are unable to become resistant.
Reports of women with chronic UTIs suggest that the drug is highly effective.
“Hiprex has changed my life,” says Helen Rawnsley, 27, of Birmingham. A private urologist prescribed her the drug in October 2020 when, after suffering from repeated urinary tract infections for three months, the antibiotics stopped working.
“It was hell,” he says. “I remember breaking up, thinking, ‘I can’t live like this.’
However, not all women can access the drug as quickly as she does. This newspaper has heard the stories of many women who can’t get a prescription for Hiprex or can’t get their pharmacist to sign a prescription, even when it’s provided by a consulting urologist.
Dr Cat Anderson, a women’s health expert who runs a clinic in London specializing in recurrent urinary tract infections, reiterated a statement made by a number of experts contacted by The Mail on Sunday that it is common for doctors headlines they haven’t even heard of methanamine.
He adds: “Many doctors, GPs and pharmacists are uncomfortable with prescribing methanamine hippocampus due to lack of knowledge about how it works.
What is the difference between effectiveness and efficiency?
The terms are often used interchangeably. However, in a medical context they have very different meanings.
In general, efficacy is related to the performance of drugs or other interventions in clinical trials.
Thus, for example, the results of the trial of a new vaccine could show that it is 80% effective, that is, those who had the vaccine had an 80% lower risk of infection than those who did not. they did.
Effectiveness, in medicine, refers to the performance of a treatment in the real world.
This is because the new vaccine itself may be gradually less potent over time, as we saw in Covid, which was due to the decrease in protective antibodies and the mutation of the virus. At the time, it could be considered, for example, only 30 percent effective.
“Beginning in the 1950s, antibiotics were seen as a kind of panacea and other treatments took a back seat. But now we know that antibiotics alone are not enough to treat many chronic urinary tract infections.” .
The guidelines set by the UK Drug Enforcement Agency, the National Institute for Health and Care Excellence (NICE), state that methanamine hypertension is “less effective” than antibiotics for treat recurrent urinary tract infections. This, however, is based on an obsolete 2016 study.
A 2019 review suggested that it was effective, especially in middle-aged and older women, while another study, published earlier this year, concluded, on average, that women with methanamine hypopurate had no more than an additional ITU per year than those taking antibiotics.
Professor Chris Harding, a consultant urologist with the Newcastle Hospitals NHS Trust who led the trial, said he was optimistic the results could encourage a change in prescribing guidelines.
Lisa Walton, a 50-year-old mother of two from Fleet, Hampshire, has spent thousands on methanamine in private for the past five years as her NHS GP refuses to prescribe it.
Prior to this, Lisa tested several rounds of antibiotics, saw a number of doctors, and even underwent surgery to expand her urethra, the narrow tube through which urine comes out of her body. prevent bacteria from getting trapped.
She says methanamine has been absolutely crucial to her recovery, adding: “I’m grateful she can afford it, but it’s absolutely essential that more people have access to it.”
Some GPs have refused to prescribe methanamine for long-term use because of the potential health risks of releasing formaldehyde, a known carcinogen, which could cause cancer.
However, Professor Harding believes that formaldehyde levels are too low to pose a risk, while Dr. Anderson says the benefits of taking methanamine far outweigh that risk, adding: “Patients with chronic UTI suffer a living hell. “. Many would see improvements if only they could be done with this drug. “