Comprehensive review on methenamine hippurate: Pharmacological activities and role in urinary tract infection prevention

• Author Details:   
• Chetana P. Bokriya ^*
• Tushar A. Dhote
• Sachin J Dighade

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UTIs are the most common global public health problem, with recurrent UTIs (rUTIs) posing a major challenge due to their impact on quality of life, increased healthcare costs, and the rising trend of antimicrobial resistance. Antibiotic prophylaxis is effective but leads to resistance; thus, new strategies are necessary. Methenamine hippurate is a non-antibiotic urinary antiseptic that has emerged as an agent for prophylaxis in rUTIs. This review summarizes current evidence in the chemical, pharmacological, and clinical aspects of methenamine hippurate to its role in preventing UTI. Methenamine hippurate consists of methenamine, which breaks down in acidic urine to release formaldehyde, and hippuric acid, improving solubility and renal excretion. Its mechanism of action involves releasing formaldehyde, a potent antimicrobial, under acidic conditions (pH < 6>

Keywords: Methenamine Hippurate, Urinary Tract Infections, Antimicrobial Resistance, Combination Therapies, Directions for Future Research