This article is more than 5 years old. Information may no longer be current.

Antibiotics bested probiotic regimen in treating UTIs in postmenopausal women

Issue: June 2012

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

Compared with a probiotic prophylaxis regimen, antibiotics prevented more recurrent urinary tract infections in a cohort of postmenopausal women with these infections.

“An increasing prevalence of antibiotic resistance among uropathogens necessitates the development of alternative non-antibiotic methods for the prevention of recurrent UTIs,” the researchers wrote. “Oral administration of Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 has been shown to restore the vaginal lactobacilli flora and to reduce colonization by potentially pathogenic bacteria.”

Between January 2005 and August 2007, the researchers randomly assigned 252 postmenopausal women with recurrent UTIs to receive 12 months of prophylaxis with trimethoprim-sulfamethoxazole 480 mg daily or oral capsules containing L. rhamnosus GR-1 and L. reuteri RC-14.

In the year before randomization, the mean number of symptomatic UTIs was seven among those assigned TMP-SMX and 6.8 among those assigned lactobacilli. After 1 year of treatment, data indicated that the mean number of symptomatic UTIs was 2.9 in the TMP-SMX group and 3.3 in the lactobacilli group. Compared with 69.3% of those in the TMP-SMX group who experienced at least one UTI, 79.1% of those in the lactobacilli group had at least one UTI. The average time to a first UTI was 6 months for those assigned TMP-SMX and 3 months for those assigned lactobacilli.

Resistance to TMP-SMX increased from about 20% to 40% to about 80% to 95% in Escherichia coli found in the feces and urine of asymptomatic women after 1 month of treatment. The researchers said this resistance decreased gradually during the 3 months after treatment discontinuation.

“In postmenopausal women with recurrent UTIs, prophylaxis with L. rhamnosus GR-1 and L. reuteri RC-14 did not meet the noninferiority criteria in the prevention of UTIs when compared with trimethoprim-sulfamethoxazole,” the researchers wrote. “However, development of antibiotic resistance is considerably lower with use of lactobacilli. Therefore, lactobacilli may be an acceptable alternative for prevention of UTIs.”

References:

• Beerepoot MA. Arch Intern Med. 2012;doi:10.1001/archinternmed.2012.777.

Disclosures:

• The researchers report no financial disclosures.