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Non-Antibiotic Prophylaxis for Urinary Tract Infections

Increasing antimicrobial resistance has stimulated interest in non-antibiotic prophylaxis of recurrent urinary tract infections (UTIs). Well-known steps in the pathogenesis of UTIs are urogenital colonization and adherence of uropathogens to uroepithelial cell receptors. To prevent colonization in p...

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Autores principales: Beerepoot, Mariëlle, Geerlings, Suzanne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4931387/
https://www.ncbi.nlm.nih.gov/pubmed/27092529
http://dx.doi.org/10.3390/pathogens5020036
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author Beerepoot, Mariëlle
Geerlings, Suzanne
author_facet Beerepoot, Mariëlle
Geerlings, Suzanne
author_sort Beerepoot, Mariëlle
collection PubMed
description Increasing antimicrobial resistance has stimulated interest in non-antibiotic prophylaxis of recurrent urinary tract infections (UTIs). Well-known steps in the pathogenesis of UTIs are urogenital colonization and adherence of uropathogens to uroepithelial cell receptors. To prevent colonization in postmenopausal women, vaginal, but not oral, estrogens have been shown to restore the vagina lactobacilli flora, reduce vaginal colonization with Enterobacteriaceae, and reduce the number of UTIs compared to placebo. Different lactobacilli strains show different results in the prevention of recurrent UTIs. Intravaginal suppositories with Lactobacillus crispatus in premenopausal women and oral capsules with Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 in postmenopausal women are promising. Ascorbic acid (vitamin C) cannot be recommended for the prevention of UTIs. Cranberries are thought to contain proanthocyanidins that can inhibit adherence of P-fimbriated E. coli to the uroepithelial cell receptors. Cranberry products decreased UTI recurrences about 30%–40% in premenopausal women with recurrent UTIs, but are less effective than low-dose antimicrobial prophylaxis. However, the optimal dose of cranberry product has still to be determined. Initially OM-89, a vaccine with 18 heat-killed E. coli extracts, seemed promising, but this was not confirmed in a recently randomized trial.
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spelling pubmed-49313872016-07-08 Non-Antibiotic Prophylaxis for Urinary Tract Infections Beerepoot, Mariëlle Geerlings, Suzanne Pathogens Review Increasing antimicrobial resistance has stimulated interest in non-antibiotic prophylaxis of recurrent urinary tract infections (UTIs). Well-known steps in the pathogenesis of UTIs are urogenital colonization and adherence of uropathogens to uroepithelial cell receptors. To prevent colonization in postmenopausal women, vaginal, but not oral, estrogens have been shown to restore the vagina lactobacilli flora, reduce vaginal colonization with Enterobacteriaceae, and reduce the number of UTIs compared to placebo. Different lactobacilli strains show different results in the prevention of recurrent UTIs. Intravaginal suppositories with Lactobacillus crispatus in premenopausal women and oral capsules with Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 in postmenopausal women are promising. Ascorbic acid (vitamin C) cannot be recommended for the prevention of UTIs. Cranberries are thought to contain proanthocyanidins that can inhibit adherence of P-fimbriated E. coli to the uroepithelial cell receptors. Cranberry products decreased UTI recurrences about 30%–40% in premenopausal women with recurrent UTIs, but are less effective than low-dose antimicrobial prophylaxis. However, the optimal dose of cranberry product has still to be determined. Initially OM-89, a vaccine with 18 heat-killed E. coli extracts, seemed promising, but this was not confirmed in a recently randomized trial. MDPI 2016-04-16 /pmc/articles/PMC4931387/ /pubmed/27092529 http://dx.doi.org/10.3390/pathogens5020036 Text en © 2016 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Beerepoot, Mariëlle
Geerlings, Suzanne
Non-Antibiotic Prophylaxis for Urinary Tract Infections
title Non-Antibiotic Prophylaxis for Urinary Tract Infections
title_full Non-Antibiotic Prophylaxis for Urinary Tract Infections
title_fullStr Non-Antibiotic Prophylaxis for Urinary Tract Infections
title_full_unstemmed Non-Antibiotic Prophylaxis for Urinary Tract Infections
title_short Non-Antibiotic Prophylaxis for Urinary Tract Infections
title_sort non-antibiotic prophylaxis for urinary tract infections
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4931387/
https://www.ncbi.nlm.nih.gov/pubmed/27092529
http://dx.doi.org/10.3390/pathogens5020036
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