2024
- Iyama Anslem Chester
- Department of Surgery, Urology Unit, Rivers State University, Port Harcourt, Rivers State, Nigeria
Recurrent urinary tract infections (rUTIs) constitute a severe clinical burden, especially for women, and are usually managed using prolonged or repeated antibiotic therapy. Such treatment instigates an antimicrobial resistance as well as disrupts host microbial milieu. A diverse number of non-antibiotic therapies such as microbiome modulation and immunoprophylaxis have emerged as potential alternatives. This study gathers evidence from randomized controlled trials (RCTs), meta-analyses, and translational studies looking into probiotics, vaccines, and microbiome-targeted therapies in the treatment of urinary tract infections(rUTIs). The effects of probiotic therapies are modest with recurrence decreases from 30% to 50% at controlled trials and may vary by strain and the approach for delivery. Immunoprophylaxis (specifically, oral bacterial vaccines MV140) with longer recurrence effects were significantly more likely and sustained protection was observed over several years. Microbiome-targeted therapies, such as fecal microbiota transplantation (FMT), present promising preliminary data but are still still to be explored. Clinical translation should be extended with integrated approaches.
