The Effect of Short-term High-dose Treatment with Methenamine Hippurate of Urinary Infection in Geriatric Patients with Indwelling Catheters

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Abstract
The urine sediment of 12 geriatric patients with indwelling catheters was quantified by the glutaraldehyde-cytocentrifuge method prior to, during and after a clinical trial of methenamine hippurate (MH), 2 g × 3 daily given for 34 days as the sole therapeutic agent for urinary tract infection. The median leukocyte concentration in the urine of these patients was 100 cells/μl (Q1 - Q3 50–350), i.e. tenfold higher than the upper normal limits reported in healthy probands. The median bacteriuria in the control period was 12 × 105 bacteria/ml urine, interquartile range 10–60 × 105 bacteria/ml and extreme individual values 300–500 × 105 bacteria/ml. Hematuria, defined as ≥ 24 erythrocytes/μl urine, was not prominent and could not be correlated with MH treatment, nor with catheter changes. The reported observations suggest that short-term high-dose treatment with MH as sole therapeutic agent reduced pyruria and bacteriuria in the group of patients studied.