Could Probiotics Be an Option for Treating and Preventing Urogenital Infections?

Gregor Reid, PhD, MBA, Andrew W. Bruce, MD, FRCS

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In This Article

The Treatment Dilemma

Maintenance of healthy vaginal flora is paramount in achieving vaginal and urinary tract health. Unfortunately, the vaginal flora are disturbed with the use of certain types of antibiotics. Antibiotics have not yet been designed to kill a single offending species. Rather, the trend has been to develop broad-spectrum agents that can be prescribed empirically with a view to killing most of the organisms in their path. A brief review of antibiotic profiles in any drug compendium will show that many are associated with side effects, including diarrhea and yeast vaginitis.[34]

The intestine has at least 400 species of bacteria totaling over 1012 organisms. These microbes aid in digestion, host defense, and other vital human functions -- an understanding of which is coming slowly from scientific literature. When they are killed, or their proportions are altered significantly, diseases such as Clostridium difficile colitis in the gut and yeast vaginitis in the genital tract can result. To address the issue of diarrhea, drugs such as nitrofurantoin have an advantage of not adsorbing in the gut and therefore potentially reducing the negative impact on the commensal flora. However, no such concerted approach has been taken for preventing yeast vaginitis. When there is no option but to give broad-spectrum agents, such as in cases of peritonitis following surgical or wound puncture, no method of restoring the gut flora post therapy has yet been devised.

In short, misuse of antibiotics coupled with bacterial ingenuity to develop resistance to their activity, as well as the lack of development of pathogen-specific antimicrobial agents, have led to the present crisis of multidrug-resistant bacteria, a fear of epidemics caused by such "super bugs," and refractory urogenital infections.

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