Probiotics for Prevention of Recurrent Urinary Tract Infections in Women
- 544 Downloads
Recurrent urinary tract infections (UTIs) afflict a great number of women around the world. The use of probiotics, especially lactobacilli, has been considered for the prevention of UTIs. Since lactobacilli dominate the urogenital flora of healthy premenopausal women, it has been suggested that restoration of the urogenital flora, which is dominated by uropathogens, with lactobacilli may protect against UTIs. This review is based on a search of PubMed for relevant articles. Many in vitro studies, animal experiments, microbiological studies in healthy women, and clinical trials in women with UTIs have been carried out to assess the effectiveness and safety of probiotics for prophylaxis against uropathogens. Most of them had encouraging findings for some specific strains of lactobacilli. Lactobacillus rhamnosus GR-1 and L. reuteri RC-14 (previously called L. fermentum RC-14) seemed to be the most effective among the studied lactobacilli for the prevention of UTIs. L. casei shirota and L. crispatus CTV-05 have also shown efficacy in some studies. L. rhamnosus GG did not appear to be quite as effective in the prevention of UTIs. The evidence from the available studies suggests that probiotics can be beneficial for preventing recurrent UTIs in women; they also have a good safety profile. However, further research is needed to confirm these results before the widespread use of probiotics for this indication can be recommended.
KeywordsLactobacillus Bacterial Vaginosis Recurrent Urinary Tract Infection Vaginal Flora Vaginal Fluid
The authors received no funding for the preparation of this manuscript and have no potential conflicts of interest directly relevant to its contents.
- 8.Bruce AW, Chadwick P, Hassan A, et al. Recurrent urethritis in women. CMAJ 1973 Apr; 108(8): 973–6Google Scholar
- 20.Silva de Ruiz C, Lopez de Bocanera ME, Nader de Macias ME, et al. Effect of lactobacilli and antibiotics on E. coli urinary infections in mice. Biol Pharm Bull 1996; 19(1): 88–93Google Scholar
- 26.Reid G, Charbonneau D, Erb J, et al. Oral use of Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 significantly alters vaginal flora: randomized, placebo-controlled trial in 64 healthy women. FEMS Immunol Med Microbiol 2003; 35: 131–4Google Scholar
- 30.Hagberg L, Bruce AW, Reid G, et al. Colonisation of the urinary tract with live bacteria from the normal fecal and urethral flora in patients with recurrent symptomatic urinary tract infections. In: Kass EH, Svanborg Eden C, editors. Host-parasite interactions in urinary tract infections. Chicago (IL): University of Chicago Press, 1989: 194–7Google Scholar
- 34.Reid G, Bruce AW, Taylor M. Instillation of Lactobacillus and stimulation of indigenous organisms to prevent recurrence of urinary tract infections. Microecol Ther 1995; 23: 32–45Google Scholar
- 36.Tomoda T, Nakano Y, Kageyama T. Intestinal Candida overgrowth and Candida infection in patients with leukemia: effect of Bifidobacterium administration. Bifidobacteria Microflora 1988; 7: 71–4Google Scholar
- 38.Kontiokari T, Laitinen J, Jarvi L, et al. Dietary factors protecting women from urinary tract infection. J Clin Nutr 2003; 77: 600–4Google Scholar
- 42.Gasser F. Safety of lactic acid bacteria and their occurrence in human clinical infections. Bull Inst Pasteur 1994; 92: 45–67Google Scholar