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Cited by 80Urinary Tract Infections ManagementProbiotics and Fermented FoodsReproductive tract infections research

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Effectiveness of Prophylactic Oral and/or Vaginal Probiotic Supplementation in the Prevention of Recurrent Urinary Tract Infections: A Randomized, Double-Blind, Placebo-Controlled Trial

Gupta, Varsha, Mastromarino, Paola, Garg, Ritu·2024·Clinical Infectious Diseases
DOI 10.1093/cid/ciad766
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Abstract

Background: Widespread antibiotic resistance has sparked interest in the identification of nonantibiotic strategies, particularly 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 1 of the 4 treatment groups: 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 1 year. The primary end points were the number of symptomatic UTIs at 4 months, the proportion of participants with at least 1 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 recurrences at 4 months was significantly lower (P < .05) in G3 (1.06) and G4 (1.07) compared with G1 (2.1) and G2 (1.63). Further, the time to first symptomatic UTI (days) was significantly longer (P < .05) in G3 (123.8) and G4 (141.8) compared with G1 (69.3) and G2 (71.9). Probiotic supplementations were well tolerated with no serious adverse events. Conclusions: Prophylactic supplementation with either vaginal probiotics or in combination with oral probiotics demonstrated effectiveness in preventing recurrent symptomatic UTI episodes. Clinical Trials Registration: Registered at Clinical Trials Registry India (CTRI): CTRI/2014/02/004425 (https://ctri.nic.in).

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Metadata

Authors
Gupta, V., Mastromarino, P., & Garg, R.
Affiliations
  • Government Medical College and Hospital (IN)
  • Sapienza University of Rome (IT)
  • Dr. B.R. Ambedkar State Institute of Medical Sciences (IN)
Corresponding author
  • Gupta, Varsha
  • Garg, Ritu
ORCID
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2023-12-12
Volume
78
Issue
5
Pages
1154-1161
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1093/cid/ciad766
OpenAlex
W4389626621
Cited by
80
References
2
Citations by year
2026: 37 · 2025: 31 · 2024: 12
FWCI
14.98
Type
journal article
Language
en
Open access
closed
Licence
academic.oup.com/pages/standard-publication-reuse-rights (vor)
Locations
  • Clinical Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
Funders
Next Gen Pharma India, Pvt. Ltd
Topics
  • Health Sciences › Medicine › Urology › Urinary Tract Infections Management
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
Keywords
recurrent urinary tract infection, probiotics, vaginal probiotics, oral probiotics, lactobacilli, lactic acid bacteria, Bifidobacterium, prophylaxis, premenopausal women, antibiotic resistance
MeSH terms
Administration, Intravaginal, Administration, Oral, Adult, Bifidobacterium, Double-Blind Method, Female, Humans, Lactobacillus, Middle Aged, Recurrence, Urinary Tract Infections, Vagina, Treatment Outcome, Dietary Supplements, Probiotics, Secondary Prevention, Young Adult

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