Use of probiotics in reducing recurrence of urinary tract infection

Abstract

Urinary tract infections (UTIs) are the most prevalent bacterial infections. Women who suffer from recurrent UTIs are more likely to acquire antibiotic resistance and have their natural microbiome disrupted if they undergo repeated treatment regimens. Consequently, antibiotic-free preventative strategies such as probiotics have been recommended as alternative treatment options. The research question for this study is: Are probiotics more effective in reducing the recurrence of UTI symptoms in women, compared to the exclusive use of regular antibiotics? The PICO elements are women with UTI (Population), probiotics (Intervention), exclusive antibiotics (Comparison), and reduced recurrence of UTI symptoms (Outcome). A search was carried out through electronic databases (HyDI, PUBMED, EBSCO, CINAHL, ProQuest, and MEDLINE), for articles published within the last 10 years, in the English language. Exclusion criteria included commentaries, newspapers, editorial, opinions and blog articles, studies conducted in the last ten years, and those conducted on men since the study is only interested in women as the primary focus. A manual search was also conducted. One systematic review and three randomized control trials were selected and critically appraised using the Critical Appraisal Skills Programme tools, according to the methodology of the study. There was no clear conclusion that probiotics can be used to prevent UTI recurrence, but they were shown to be effective in three out of the four studies reviewed: the other study reporting no significant difference between the two regimens (antibiotics vs prebiotics). This implies that individual women may respond to different regimens and perhaps even combination treatment. Recommendations include the need for nurses and the entire medical team to critically assess women and identify how they respond to different regimens and combination treatments to mitigate adverse reactions. Besides, there is a need for more evidence-based research on larger samples to examine the efficacy of probiotics as a prophylactic measure for recurrent UTIs, the best probiotic strains, the optimal duration probiotics use and the ideal dose for preventing UTI recurrence.