Probiotics in Preventing Recurrent Urinary Tract Infections in Women: A Literature Review

Annie H. Chisholm, RN

Disclosures

Urol Nurs. 2015;35(1):18-21. 

In This Article

Abstract and Introduction

Abstract

Increasing antibiotic resistance and increasing resistance to commonly used antibiotics makes treatment and prevention of urinary tract infections difficult. Although more research is needed, probiotics should be considered a useful and safe alternative to antibiotics.

Introduction

Urinary tract infections (UTIs) are one of the most common bacterial infections in women, accounting for over 6 million primary care visits annually (Zak, 2014). Approximately 50% to 60% of women will develop a UTI in their lifetime (Al-Badr & Al-Shaikh, 2013), and one-third of women will experience at least one UTI by age 26 (Giesen, Cousins, Dimitrov, van de Laar, & Fahey, 2010).

Treatment is often complicated by the high rates of reoccurrence. Approximately 20% to 30% of women with a UTI will have a reoccurrence (Beerepoot, Geerlings, van Haarst, van Charante, & ter Riet, 2013); 10% to 20% of women with a UTI will experience another within a few months, and 27% within six to 12 months (Fihn, 2003; Franco, 2005; Zak, 2014). Ikaheimo et al. (1996) found that in the primary care setting, 53% of women over 55 years of age and 36% of younger women will have a reoccurrence within a year. Women are diagnosed with recurrent UTIs if they have three UTIs with three positive urine cultures within a 12-month period or two infections in the previous six months (Al-Badr & Al-Shaikh, 2013).

Symptoms of UTIs include dysuria, frequency, urgency, nocturia, suprapubic pain, and hematuria, all of which significantly affect the quality of life. Contributing factors to UTIs include inadequate hydration, voiding patterns, diaphragm and spermicide use, tight undergarments, wiping technique, immuno-suppression, postmeno pausal women, diabetes mellitus, and frequent sexual intercourse (Al-Badr & Al-Shaikh, 2013). Escheria coli (E. coli) causes the majority of UTIs in women, accounting for 75% to 95% of infections (Al-Badyr & Al-Shaikh, 2013; Nosseir, Lind, & Winkler, 2012). Recurrent UTIs are most often (~80% of time) caused by reinfection with the same pathogen (Al-Badyr & Al-Shaikh, 2013; Nosseir et al., 2012).

Continuous antibiotics are currently used as treatment and prophylaxis for recurrent UTIs. The literature recommends treating anywhere from 6 to 12 months to 2 to 5 years (Zak, 2014). However, the long-term effects of antibiotics are unknown. We are currently in an age of increasing antibiotic resistance, and increasing resistance to commonly used antibiotics, such as trimethoprim-sulfamethoxazole (Gupta, Hooton, & Stamm, 2001), makes treatment and prevention of infections difficult. Therefore, finding safe and effective alternatives to preventing recurrent UTIs in women is imperative. This article will examine the evidence on the role of probiotics in preventing recurrent UTIs in women.

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