Can vaginal lactobacillus suppositories help reduce urinary tract infections?

Autor: Shoureshi PS; Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA. poone.shoureshi@cshs.org., Niino C; Department of Obstetrics & Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Eilber KS; Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Jazyk: angličtina
Zdroj: International urogynecology journal [Int Urogynecol J] 2023 Nov; Vol. 34 (11), pp. 2713-2718. Date of Electronic Publication: 2023 Jul 01.
DOI: 10.1007/s00192-023-05568-4
Abstrakt: Introduction and Hypothesis: Recurrent urinary tract infections (rUTIs) are a burden to patients and the health care economy. Vaginal probiotics and supplements have gained significant attention in mainstream media and lay press as a non-antibiotic alternative. We performed a systematic review to determine whether vaginal probiotics are an effective means of prophylaxis for rUTI.
Methods: A PubMed/MEDLINE article search was performed from inception to August 2022 for prospective, in vivo use of vaginal suppositories for the prevention of rUTIs. Search terms included: vaginal probiotic suppository (34 results), vaginal probiotic randomized (184 results), vaginal probiotic prevention (441 results), vaginal probiotic UTI (21 results), and vaginal probiotic urinary tract infection (91 results). A total of 771 article titles and abstracts were screened.
Results: A total of 8 articles fit the inclusion criteria and were reviewed and summarized. Four were randomized controlled trials, with 3 of the studies having a placebo arm. Three were prospective cohort studies, and 1 was a single arm, open label trial. Five of the 7 articles that specifically evaluated for rUTI reduction with vaginal suppositories did find a decreased incidence with probiotic use; however, only 2 had statistically significant results. Both of these were studies of Lactobacillus crispatus and were not randomized. Three studies demonstrated the efficacy and safety of Lactobacillus as a vaginal suppository.
Conclusion: Current data support the use of vaginal suppositories containing Lactobacillus as a safe, non-antibiotic measure, but actual reduction of rUTI in susceptible women remains inconclusive. The appropriate dosing and duration of therapy remain unknown.
(© 2023. The Author(s).)
Databáze: MEDLINE
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