Effectiveness of prophylactic oral and/or vaginal probiotic supplementation in the prevention of recurrent urinary tract infections: A randomized, double-blind, placebo-controlled trial
Abstract
BACKGROUND
Widespread antibiotic resistance has sparked interest in the lookout for non-antibiotic strategies, particularly focusing on probiotics for the prevention of recurrent urinary tract infections (UTIs). We evaluated the effectiveness of prophylactic probiotic supplementation through oral and intravaginal routes in the prevention of recurrent UTIs.
METHODS
This double-blind, placebo-controlled study enrolled 174 premenopausal women with a history of recurrent UTIs and randomized them to either of the four treatment groups, namely, Placebo (G1, oral placebo+vaginal placebo); Oral probiotic (G2, oral lactic acid bacteria and bifidobacteria+vaginal placebo); Vaginal probiotic (G3, oral placebo+vaginal lactobacilli); and Probiotic combination (oral lactic acid bacteria and bifidobacteria+vaginal lactobacilli), for 4 months. Participants were followed-up for symptomatic UTIs for one year. The primary endpoints were the number of symptomatic UTIs at 4 months, the proportion of subjects with at least one symptomatic UTI, and the time to the first symptomatic UTI.
RESULTS
The incidence of UTI at 4 months in G1, G2, G3 and G4 was 70.4%, 61.3%, 40.9%, and 31.8%, respectively. The mean number of symptomatic UTI recurrence at 4 months was significantly lower (p<0.05) in G3 (1.06) and G4 (1.07) compared to G1 (2.1) and G2 (1.63). Further, the time to first symptomatic UTI (days) was significantly longer (p<0.05) in G3 (123.8) and G4 (141.8) compared to G1 (69.3) and G2 (71.9).…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 174 participants or records.
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