Probiotic and cranberry supplement: One of the promising agents to treat recurrent UTIs

Probiotics and cranberry supplements can significantly help to reduce recurrent urinary tract infections (rUTIs) in premenopausal women, as well as helps to shorten the duration of infections and also reduces the need for antibiotic treatment, stated by a study.¹ Urinary tract infections (UTIs) are highly prevalent, and can lead to considerable patient morbidity, and incur large financial costs to healthcare systems and stands as one of the most common reasons for antibiotic use worldwide.²

A study published in the journal Beneficial Microbiomes, The double-blind randomized clinical trial, included around 60 male-to-female transsexual women with neovagina; an open label RCT in 60 pregnant women with herpes virus infection; a DB-RCT in 36 women with bacterial vaginosis; a DB-RCT in 22 postmenopausal breast cancer patients receiving chemotherapy. Only in the three DB-RCTs Nugent score was assessed. ⁵

The patients received four Lactobacillus strains (Lactobacillus crispatus LbV 88 (DSM 22566), Lactobacillus gasseri LbV 150N (DSM 22583), Lactobacillus jensenii LbV 116 (DSM 22567) and Lactobacillus rhamnosus LbV 96 (DSM 22560) which were administered orally. For this purpose a systematic review and meta-analysis of randomised clinical trials (RCTs) in which the effect of oral administration of a mixture of these Lactobacillus strains on vaginal dysbiosis was examined based on Nugent score.

Dr Ashton Harper, medical director at ADM Protexin Limited, says. “UTIs are one of the top most common types of infection with the highest incidences occurring in adult women.

Results⁵

A significant reduction in the nugent score was observed i.e. by 0.5 points is equivalent to 8.3% of the mean Nugent score (5.9 points) of all women in the three studies. The effect of the probiotics is therefore relevant taking the good correlation between Nugent score and the burden of vaginal dysbiosis and between Nugent score and other studies. 

This meta-analysis indicates that the oral intake of a probiotic containing L. crispatus LbV 88 (DSM 22566), L. gasseri LbV 150N (DSM 22583), L. jensenii LbV 116 (DSM 22567) and L. rhamnosus LbV96 (DSM 22560), either as yoghurt or in capsule form, may improve the microbial pattern (measured as Nugent score) in different forms of vaginal dysbiosis.

Antibiotic overuse⁴

Antibiotics are more commonly prescribed to patients as they leave the hospital. The researchers hoped that their findings will be able to provide relief from the overuse of antibiotics and the substantial demands placed on the NHS.

“Urinary tract infections have a very significant impact on patient’s quality of life and are also responsible for a substantial proportion of antibiotics prescribed in the community.” Stated by Dr Mohammed Naveed Baig.

“The sudden decrease in the frequency of the recurrent infections and courses of antibiotics identified in this study are very promising. Further on large scale trials are needed to validate these positive results.”

Prof Glenn Gibson, Professor of food microbiology and also head of food microbial sciences at the University of Reading gave his insight into the potential mechanisms behind the results.

“The mechanisms of action for the following is likely to be direct inhibition of pathogens which are completely responsible for UTIs, as well as for overall immune stimulation, he suggested.³

“The add-on benefit is that good probiotic are very safe to be used by humans and therefore carry negligible risk.

“This is a reported study and was well conducted that adds to the body of important data on the positive effects of probiotics. UTIs are a source of much pain and discomfort for millions of women worldwide and anything that can be done to alleviate this is certainly welcome. It is good to see in vivo studies such as this, as these provide a much more reliable assessment of impact than laboratory or animal models.”

According to Dr Harper he hoped that future research conducted in the hospital setting, with additional patient sub-groups, will help to broaden the scope of application of the supplement even further. 

References:

1. Koradia P, Kapadia S, Trivedi Y, Chanchu G, Harper A. Probiotic and cranberry supplementation for preventing recurrent uncomplicated urinary tract infections in premenopausal women: a controlled pilot study. Expert review of anti-infective therapy. 2019 Sep 2;17(9):733-40.

2. Sihra N, Goodman A, Zakri R, Sahai A, Malde S. Nonantibiotic prevention and management of recurrent urinary tract infection. Nature Reviews Urology. 2018 Dec;15(12):750-76.

3. Jepson RG, Williams G, Craig JC. Cranberries for preventing urinary tract infections. Cochrane database of systematic reviews. 2012(10).

4. Vaughn VM, Gandhi TN, Chopra V, Petty LA, Giesler DL, Malani AN, Bernstein SJ, Hsaiky LM, Pogue JM, Dumkow L, Ratz D. Antibiotic overuse after hospital discharge: a multi-hospital cohort study. Clinical infectious diseases. 2021 Dec 1;73(11):e4499-506.
5. De Vrese M, Laue C, Papazova E, Petricevic L, Schrezenmeir J. Impact of oral administration of four Lactobacillus strains on Nugent score–systematic review and meta-analysis. Beneficial microbes. 2019 May 28;10(5):483-96.