Tackling antimicrobial resistance with formaldehyde: A potential solution to treatment of urinary tract infections

Antimicrobial resistance has been increasingly identified as a growing societal and global concern. The main cause is linked to the increased use of antibiotics. How can we balance the approach between these medical solutions versus the diseases and infections they tackle?

In the case of urinary tract infections, formaldehyde may have a role to play. A well-known antibiotic which has been considered for many years as an adequate preventive treatment to cure people suffering from chronic urinary tract infections, was associated with more and more resistance of the bacteria Escherichia coli (E coli), responsible for this type of infection, meaning that patients are less responsive to the treatment.

It was recently discovered that formaldehyde can be used as a building block to produce a new treatment for the prevention of urinary tract infections, Methenamine Hippurate. Formaldehyde is known for its action against bacteria and is effective against E coli.

Based on these new insights, eight medical centres in the UK compared in 2018 the effectiveness of the existing antibiotic and Methenamine Hippurate in these prevention treatments in patients. A comparative assessment was performed to evaluate the pros and cons in using both solutions.

The results of this comparative assessment have shown a similar degree of effectiveness to treat patients from suffering from urinary tract infection. Secondary effects were reported in equivalent levels, but all reported reactions were mild. Finally, no effect of bacterial resistance to Methenamine Hippurate was reported; this means that this alternative treatment may be an opportunity to effectively treat patients without the very much negative building resistance effect cause by the antibiotic.

More research will be needed in this area before the medical sector can issue a generally accepted recommendation to stop the use of antibiotics in this context. However, this shows that the solutions to existing issues can be found in unexpected places. We just need to keep looking.

Source: https://www.bmj.com/content/376/bmj-2021-0068229.short?rss=1