Daily Nitrofurantoin Versus Bladder Fulguration Plus Daily Nitrofurantoin for Women With Recurrent Urinary Tract Infections

NCT ID: NCT06907199

Last Updated: 2025-12-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

PHASE1

Total Enrollment

104 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-01-31

Study Completion Date

2029-01-30

Brief Summary

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The goal of this clinical trial is to learn if the drug Nitrofurantoin (NF) taken as a daily antibiotic, works to treat cystitis compared to electrofulguration (EF) and Nitrofurantoin (NF) daily antibiotic.

Detailed Description

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This is a study for women age 18 -85 with a well-documented history of rUTI (recurrent urinary tract infection) for at least one year. This randomized multicentric clinical trial will determine the efficacy of conventional 6 months Nitrofurantoin (NF) daily antibiotic prophylaxis alone versus electrofulguration (EF) associated with a 6 months NF daily antibiotic prophylactic course for early stages of chronic cystitis (stages 1 and 2) as determined on office cystoscopy.

This study will ask the participant (n=104) to return to the Urology clinic at UT Southwestern Medical Center (n=52) or The University of Kansas Medical Center (n=52) for a total of 8 compensated visits throughout 30 months after the start of this randomized trial to make sure that the treatment worked well for them.

Conditions

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Recurrent UTIs Cystitis Recurrent

Keywords

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bladder fulguration Nitrofurantoin long-term managenent of cystitis Recurrent UTI chronic UTI

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Nitrofurantoin (NF) daily antibiotic prophylaxis plus electrofulguration (EF)

Group Type EXPERIMENTAL

Electrofulguration (EF)

Intervention Type PROCEDURE

Nitrofurantoin (NF) daily antibiotic prophylaxis for 6 months plus Electrofulguration.

Nitrofurantoin (NF)

Intervention Type DRUG

Nitrofurantoin (NF) daily antibiotic prophylaxis given daily for 6 months.

Nitrofurantoin (NF) daily antibiotic prophylaxis

Nitrofurantoin (NF) daily antibiotic prophylaxis given daily for 6 months.

Group Type ACTIVE_COMPARATOR

Nitrofurantoin (NF)

Intervention Type DRUG

Nitrofurantoin (NF) daily antibiotic prophylaxis given daily for 6 months.

Interventions

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Electrofulguration (EF)

Nitrofurantoin (NF) daily antibiotic prophylaxis for 6 months plus Electrofulguration.

Intervention Type PROCEDURE

Nitrofurantoin (NF)

Nitrofurantoin (NF) daily antibiotic prophylaxis given daily for 6 months.

Intervention Type DRUG

Other Intervention Names

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fulguration

Eligibility Criteria

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Inclusion Criteria

* Females 18 to 85 years old with at least a 1-year history of culture documented uncomplicated rUTI.
* Diagnosis of rUTI, defined as ≥ 3 symptomatic UTIs in 12 months or ≥ 2 in 6 months.
* Currently free from a UTI determined based on absence of symptoms as determined by the UTI symptom assessment questionnaire and negative urine culture (\<10\^3 colony forming units per ml of urine).
* A negative upper and lower urinary tract evaluation, including pelvic examination for pelvic organ prolapse (less than or equal to stage 2), measurement of post-void residual (less than 50 ml), and imaging (which may include renal ultrasound and standing voiding cystourethrogram) to exclude kidney stone, hydronephrosis, reflux, or urethral diverticulum.
* Office cystoscopy documenting stages 1 or 2 of chronic cystitis.
* Likely to stay in the geographic region for the duration of the study.
* ASA class II or less.

Exclusion Criteria

* Patients on antibiotics at baseline (i.e., suppressive therapy or antibiotic therapy for non-urinary infections).
* Patients on self-start therapy (i.e., taking antibiotics upon start of urinary symptoms concerning for UTI).
* Patients on prophylactic antibiotics started in the last 3 months and unwilling to discontinue, or intention to start in the next 12 months.
* Complicated UTIs, including neurogenic bladder condition (i.e., multiple sclerosis, Parkinson's disease, spinal cord injury), bladder augmentation, or urinary diversion.
* Patients with urinary catheters (including indwelling Foley, intermittent catheterization, and suprapubic catheters).
* Uncontrolled diabetes (HbA1c \>9).
* Pregnancy
* Allergy or resistance to Nitrofurantoin.
* Chronic lung or liver condition precluding the use of Nitrofurantoin, including abnormal chest X ray or elevated liver function tests.
* Chronic renal insufficiency (creatinine over 1.5 g/dl or GFR less than 40) precluding the use of Nitrofurantoin.
* History of chronic diarrhea requiring regular therapy.
* Patients with psychosis, dementia, swallowing disorders, or any other ability to take Nitrofurantoin reliably at home.
* BMI over 40.
* Use of Uromune or other vaccine approaches to reduce rUTI episodes
* Participation in a research study involving an investigational product in the past 12 weeks.
* Patients receiving phage therapy.
* Current diagnosis of interstitial cystitis.
* Patients with medical conditions requiring excessively large amounts of fluid intake.
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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University of Texas

OTHER

Sponsor Role collaborator

National Institutes of Health (NIH)

NIH

Sponsor Role collaborator

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

University of Texas Southwestern Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Philippe Zimmern

Professor of Urology

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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The University of Kansas

Kansas City, Kansas, United States

Site Status

UT Southwestern Medical Center

Dallas, Texas, United States

Site Status

Countries

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United States

Central Contacts

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Meghan Leak

Role: CONTACT

Phone: 214-645-8787

Email: [email protected]

Facility Contacts

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Colby Souders, MD

Role: primary

Meghan B Leak

Role: primary

Jessica de Araujo Paula

Role: backup

Other Identifiers

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1R01DK140224-01A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

STU-2024-1187

Identifier Type: -

Identifier Source: org_study_id