Background: Urinary tract infections (UTI) are common in renal transplant recipients (RTR). Methenamine hippurate is a non-antibiotic drug that inhibits bacterial growth in the bladder and should prevent recurrent UTI in adult RTR.

Methods: Retrospectively, RTR ≥18 years old treated with methenamine for recurrent UTI at Northwestern Memorial Hospital from 2006-2017 were included in the study. Electronic medical health record data was collected and analyzed using zero-inflated Wilcoxon signed-rank tests after IRB approval.

Results: Sixty-one patients were identified, and 46 included in the final analysis. The median and range for follow-up days were 365 (103-365) pre- vs 291 (9-365) post-methenamine. Of the 30 patients who consulted with urology, 8 had nephrolithiasis, 2 had fistulas and 1 had a kidney lesion. UTI frequency (median 2.8 UTI/year vs 0.5), antibiotic prescription (See Tables and figure) and hospitalization due to UTI (2.4/1000 follow-up days vs. 0.9) decreased with use of methenamine. E. coli and K. pneumoniae were the most commonly isolated cause of UTI both pre- and post-intervention. MDR-bacteria affected 6 patients pre- and 4 of the same plus 2 new patients post-methenamine. Methenamine was also well tolerated (2 patients had nausea, 1 had a rash, 1 was intolerant).

Conclusion: Methenamine is well tolerated and is useful in reducing UTI and antibiotic prescription in RTR with recurrent UTI. Larger prospective studies are needed to confirm these findings.

CITATION INFORMATION: Hollyer I., Varias F., Ho B., Ison M. Assessment of Methenamine Hippurate for the Prevention of Recurrent Urinary Tract Infections in Adult Renal Transplant Recipients: A Single Center, Retrospective Study Am J Transplant. 2017;17 (suppl 3).

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