RecruitingPHASE2INTERVENTIONAL

A Clinical Trial of Extended (High) Treatment Dose Antibiotics in Combination With Methenamine Hippurate Compared to the Standard of Care (Either Prophylactic (Low) Dose Antibiotic Treatment or Methenamine Hippurate) in Females With Chronic Urinary Tract Infection

This study, called EAT-UP, is looking for better ways to treat women with chronic urinary tract infections (UTIs). These are infections where symptoms like needing to pee often, bladder pain, or discomfort are constant, unlike regular UTIs that come and go. Current treatments often don't work well for chronic UTIs, and standard urine tests can miss them. This trial will test if a stronger course of antibiotics combined with a urine antiseptic called methenamine hippurate is more effective at reducing infection and symptoms than the usual treatments, which are lower-dose antibiotics or methenamine hippurate on its own. The study aims to help many women who suffer from persistent UTI symptoms.

At a glance

Status

Recruiting

Phase

PHASE2

Sponsor

University College, London

Enrolment target

192

Start

26 Feb 2026

Estimated completion

01 Nov 2027

Chronic Urinary Tract Infection

What is this study about?

If you're a woman who experiences constant urinary tract infection (UTI) symptoms every single day, you might have what doctors call a chronic UTI. This is different from recurrent UTIs, where you get infections often but have symptom-free breaks in between. Unfortunately, the usual treatments for recurrent UTIs, like low-dose antibiotics taken daily to prevent infection or a medicine called methenamine hippurate, often don't help much for chronic UTIs, and symptoms can carry on.

This is why researchers are running the EAT-UP trial. They want to find a more effective solution. The study will investigate whether taking a stronger dose of antibiotics over a longer period, combined with methenamine hippurate (which helps keep your urine free of bacteria), works better than the standard treatments currently available on the NHS. For many women, chronic UTIs can be very distressing, and standard urine tests often don't show an infection, making it even harder to get the right treatment.

The main goal of the EAT-UP trial is to see if this new treatment approach can significantly reduce the level of infection and ease your symptoms more effectively than what's currently offered. By comparing these different methods, the researchers hope to find a better way to help women live more comfortably without the constant burden of chronic UTI symptoms.

Key takeaways

Targets difficult-to-treat chronic UTIs in women.
Compares a new combination treatment to standard care.
Aims to reduce infection levels and improve symptoms.
Involves 12 weeks of treatment with regular check-ups.
Your doctor will choose your specific antibiotic based on your needs.

Who may be eligible?

This study is specifically for women aged 18 or over who have been diagnosed with a chronic urinary tract infection. This means you've had daily, constant symptoms like needing to pee often, urgency, bladder pain, or pain when peeing for at least three months. Importantly, your doctor should believe these symptoms are due to a chronic UTI and that you've had some relief from antibiotics in the past, even if it was short-lived. Tests will also need to show a certain level of white blood cells in your urine.

To join, you must not have any major long-term health conditions that affect your kidneys or bladder, such as kidney stones or significant prolapse. You also shouldn't be taking certain medications like immune-modulating drugs or specific diabetes medications called SGLT2 inhibitors. Your kidneys also need to be working well enough, and you must be able to take at least one of the antibiotics being tested in the study or methenamine hippurate.

The researchers are looking for women who can commit to attending all study appointments and following the trial's instructions properly for the duration of the study. You'll also need to be happy to give your informed consent, which means you understand what the study involves and agree to take part.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you a woman aged 18 or over?
Have you had chronic UTI symptoms daily for at least 3 months?
Do you have no major kidney or bladder problems (like kidney stones or significant prolapse)?
Are you able to take the study medications (antibiotics/methenamine hippurate)?
Can you attend regular clinic visits for 12 weeks?

Answer every question to see your result.

What does participation involve?

If you decide to take part in this study, you'll first have a screening visit to make sure you're suitable. If you are, you'll be randomly placed into one of two groups. Neither you nor your doctor will get to choose which group you join – it's like flipping a coin to keep the study fair.

One group will receive a stronger, "treatment dose" of an antibiotic chosen by your doctor, along with methenamine hippurate. The other group will receive either a lower-dose daily antibiotic or methenamine hippurate on its own, again chosen by your doctor based on your needs. You will take the study medication for 12 weeks.

During these 12 weeks, you'll need to visit the clinic every 4 weeks for assessments. These visits will involve filling out questionnaires about your symptoms and providing samples of blood, urine, and swabs from the area between your vagina and anus. This helps the researchers understand how well the treatments are working and monitor your health.

Potential risks and benefits

Participating in this study might offer you the potential benefit of a more effective treatment for your chronic UTI symptoms than currently available. However, like all medicines, the treatments in this study can have side effects. You might experience common antibiotic side effects like stomach upset, and your doctor will discuss these with you. You are free to withdraw from the study at any time, for any reason, without it affecting your usual medical care.

Locations (5)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust
Verified postcode
London, United Kingdom· Not yet recruiting
University College London Hospital (UCLH), UCLH NHS Foundation Trust
Verified postcode
London, United Kingdom· Not yet recruiting
Whittington Hospital, Whittington Health NHS Trust
Verified postcode
London, United Kingdom· Recruiting
St Mary's Hospital, Manchester University NHS Foundation Trust
Verified postcode
Manchester, United Kingdom· Not yet recruiting
Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust
Verified postcode
Newcastle upon Tyne, United Kingdom· Recruiting

Common questions

What is a chronic UTI?

A chronic UTI means you have constant, daily symptoms of a urinary tract infection, like frequent urination or bladder pain, for a long time.

How is this different from a recurrent UTI?

With recurrent UTIs, symptoms come and go with clear breaks, but with chronic UTIs, the symptoms are always there.

What treatments are being compared?

The study compares a stronger course of antibiotics with methenamine hippurate against standard treatments like low-dose antibiotics or methenamine hippurate alone.

How long will I be on the study medication?

You will take the study medication for a total of 12 weeks.

Will I know which treatment I'm getting?

Yes, this is an 'open-label' study, meaning both you and your doctor will know which treatment you are receiving.

How to find out more

EAT-UP Trial Team

cctu.eat-up@ucl.ac.uk 020 3108 5298 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.