Vaginal probiotics reduce the incidence of recurring urinary tract infections (UTIs). The finding suggests the treatment is a promising alternative to antibiotics, many of which are no longer effective against UTIs.
UTIs occur when pathogens enter and infect the urinary tract, causing painful burning sensations, frequent urination and cramping. They are commonly treated with antibiotics, though many of the bacteria that cause UTIs have developed resistance to these drugs.
Previous research showed that women with recurring UTIs 鈥� defined as three or more infections in a year 鈥� had low levels of beneficial bacteria in their vaginas. So, at the Government Medical College & Hospital in India and her colleagues examined whether they could be treated with probiotics, or live strains of beneficial bacteria.
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The researchers randomly divided 174 premenopausal women into four groups. The participants were all between 18 and 45 years old, lived in India and had a history of recurring UTIs. One group received a vaginal probiotic and an oral placebo. Another took an oral probiotic and a vaginal placebo. The third group received a vaginal and oral probiotic, while the rest were given an oral and vaginal placebo. All the women were instructed to take the oral pills twice daily and insert the vaginal tablet once daily for eight consecutive days a month.
After four months, the researchers found that less than 32 per cent of those in the vaginal plus oral probiotic group developed a UTI, while 41 per cent of those in the vaginal-only probiotic group did. About 61 per cent of women taking only the oral probiotic developed a UTI and more than 70 per cent taking neither probiotic did.
鈥淸These findings] demonstrate that the use of oral and vaginal probiotics can actually make a difference in reducing the frequency of UTIs,鈥� says at Northwell Health in New York. This is important for preventing UTIs and the overuse of antibiotics, which increases the likelihood of bacteria developing antibiotic resistance, she says.
However, it is unclear how these vaginal and oral probiotics stopped UTIs from occurring, says at Massachusetts General Hospital. She says she would like to have seen sequencing of the participants鈥� vaginal microbiomes to see the composition of bacteria. 鈥淗ow does that change? Do [probiotics] change the function of bacteria already there? How sustained is that? Is that displacing pathogens? That鈥檚 where we鈥檙e missing a lot of scientific data in the field generally, not just in this paper.鈥�
There are some ideas as to how probiotics treat UTIs. For instance, beneficial microbes could discourage the growth of pathogenic bacteria, which tend to travel from the vagina to the urinary tract, by producing hydrogen peroxide, says Rabin. This acidic substance may make the vagina less hospitable to pathogens, she says.
Clinical Infectious Diseases
