EAT-UP
Research type
Research Study
Full title
EAT-UP - Extended Antibiotic Treatment in chronic UTI Patients; a phase II safety and efficacy trial
IRAS ID
1011957
Contact name
Rajvinder Khasriya
Contact email
Sponsor organisation
University College London Comprehensive Clinical Trials Unit
ISRCTN Number
ISRCTN17592593
Clinicaltrials.gov Identifier
Research summary
Chronic Urinary Tract Infection (UTI) is a condition where patients experience persistent urinary tract infections with daily symptoms. It is a recently recognised type of UTI. Currently, treatment for chronic UTI follows NICE guidelines for recurrent UTIs (characterised by frequent infections with symptom-free periods in between). This includes short courses of treatment-dose antibiotics, extended courses of low-dose prophylactic antibiotics or methenamine hippurate monotherapy. These treatments are often ineffective for chronic cases. The purpose of this trial is to assess whether extended courses of treatment-dose antibiotics, combined with the urinary antiseptic methenamine hippurate, is more effective at treating chronic UTI than standard treatment of either low-dose prophylactic antibiotics or methenamine hippurate monotherapy over 12 weeks. It will also assess whether this approach is safe and feasible. The trial will also use fresh urine microscopy to detect white blood cells as an indicator of infection, as standard tests used in the NHS, such as urine cultures and dipstick analysis, often fail to identify chronic infections. The trial will take place at an estimated five NHS hospital locations across the UK and will include 192 participants aged 18 and over who have experienced chronic UTI symptoms for at least 3 months.
Participants will be divided into two groups:
• One group will receive a treatment-dose antibiotic (chosen from Cefalexin 500mg four times daily, Nitrofurantoin 100mg twice daily, or Trimethoprim 200mg twice daily), along with methenamine hippurate (1g twice daily).
• The other group will receive a low-dose prophylactic antibiotic (chosen from Cefalexin 125mg once daily, Nitrofurantoin 50mg once daily, Trimethoprim 100mg once daily, or Amoxicillin 250mg once daily) or methenamine hippurate (1g twice daily).Participants will be asked to provide questionnaires, blood samples, urine samples, and perineal swabs.
REC name
Wales REC 3
REC reference
25/WA/0300
Date of REC Opinion
5 Nov 2025
REC opinion
Further Information Favourable Opinion