Original Article

Spinal Cord (2007) 45, 542–550; doi:10.1038/sj.sc.3101974; published online 17 October 2006

Spinal-injured neuropathic bladder antisepsis (SINBA) trial

Sponsorship: (1) Motor Accidents Authority of New South Wales (2) Brucia Pharmaceuticals (non-financial)

B B Lee1,2,3, M J Haran4, L M Hunt4, J M Simpson2, O Mariall, S B Rutkowski2,4, J W Middleton2,5, G Kotsiou2,4, M Tudehope6 and I D Cameron2,5

  1. 1Spinal Medicine Department, Prince of Wales Hospital, Sydney, New South Wales, Australia
  2. 2University of Sydney, New South Wales, Australia
  3. 3University of New South Wales, New South Wales, Australia
  4. 4Royal North Shore Hospital, Sydney, New South Wales, Australia
  5. 5Royal Rehabilitation Centre, Sydney, New South Wales, Australia
  6. 6North Shore Private Hospital, Sydney, New South Wales, Australia

Correspondence: BB Lee, Spinal Medicine Department, Prince of Wales Hospital, High street entrance lvl 2, Randwick, Sydney, NSW 2031, Australia

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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.

Keywords:

urinary tract infection, neuropathic bladder, cranberry, methenamine hippurate, prophylaxis, spinal cord injury

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