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