Urinary tract infections are one of the most common infections worldwide, accounting in the United Kingdom for 1–3% of all medical consultations. Fifty per cent of women will experience one episode of urinary tract infection in their lifetimes and of these, up to 30% will develop recurrent urinary tract infections. Such women often rely on long-term low dose antibiotics.
Level of evidence: Not applicable for this multicentre audit.
FoxmanB.Urinary tract infection syndromes: occurrence, recurrence, bacteriology, risk factors, and disease burden. Infect Dis Clin North Am. 2014; 28: 1–13.
2.
PriceJRGuranLAGregoryWT, et al. Nitrofurantoin vs other prophylactic agents in reducing recurrent urinary tract infections in adult women: a systematic review and meta-analysis. Am J Obstet Gynecol2016; 215: 548–560.
3.
AlbertXHuertasIPereiroII, et al. Antibiotics for preventing recurrent urinary tract infection in non-pregnant women. Cochrane Database Syst Rev2004; (3):CD001209.
4.
ScholesDHootonTMRobertsPL, et al. Risk factors for recurrent urinary tract infection in young women. J Infect Dis2000; 182: 1177–1182.
BergaminPAKiosoglousAJ.Surgical management of recurrent urinary tract infections: a review. Transl Androl Urol2017; 6 (Suppl. 2): S153–S162.
7.
LivermoreDM.Has the era of untreatable infections arrived?J Antimicrob Chemother2009; 64 (Suppl. 1): i29–i36.
8.
GuptaADwivediMMahdiAA, et al. Inhibition of adherence of multi-drug resistant E. coli by proanthocyanidin. Urol Res2012; 40: 143–150.
9.
NicolosiDTemperaGGenoveseC, et al. Anti-adhesion activity of A2-type proanthocyanidins (a cranberry major component) on uropathogenic E. coli and P. mirabilis strains. Antibiotics (Basel)2014; 3: 143–154.
10.
MargetisDRouxDGaudryS, et al. Effects of proanthocyanidins on adhesion, growth, and virulence of highly virulent extraintestinal pathogenic Escherichia coli argue for its use to treat oropharyngeal colonization and prevent ventilator-associated pneumonia. Crit Care Med2015; 43: e170–e178.
11.
JensenHDStruveCChristensenSB, et al. Cranberry juice and combinations of its organic acids are effective against experimental urinary tract infection. Front Microbiol. 2017; 8: 542.
KranjcecBPapesDAltaracS.D-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial. World J Urol2014; 32: 79–84.
15.
MichaelsEKChmielJSPlotkinBJ, et al. Effect of D-mannose and D-glucose on Escherichia coli bacteriuria in rats. Urol Res1983; 11: 97–102.
16.
BatesJMRaffiHMPrasadanK, et al. Tamm–Horsfall protein knockout mice are more prone to urinary tract infection: rapid communication. Kidney Int2004; 65: 791–797.
17.
DomeniciLMontiMBracchiC, et al. D-mannose: a promising support for acute urinary tract infections in women. A pilot study. Eur Rev Med Pharmacol Sci2016; 20: 2920–2925.
18.
VDELCappelliVMassaroMG, et al. [Evaluation of the effects of a natural dietary supplement with cranberry, Noxamicina(R) and D-mannose in recurrent urinary infections in perimenopausal women]. Minerva Ginecol2017; 69: 336–341.
19.
GenoveseCDavinelliSManganoK, et al. Effects of a new combination of plant extracts plus D-mannose for the management of uncomplicated recurrent urinary tract infections. J Chemother2018; 30: 1–8.
20.
NilssonS.Long-term treatment with methenamine hippurate in recurrent urinary tract infection. Acta Med Scand1975; 198: 81–85.
21.
YangBFoleySToozs-HobsonP.Urinary tract infections: current and new preventative options. SM J Clin Med2016; 2: 1018.
22.
LeeBSBhutaTSimpsonJM, et al. Methenamine hippurate for preventing urinary tract infections. Cochrane Database Syst Rev2012; 10: CD003265.
23.
FalagasMEBetsiGIAthanasiouS.Probiotics for prevention of recurrent vulvovaginal candidiasis: a review. J Antimicrob Chemother2006; 58: 266–272.
24.
StapletonAEAu-YeungMHootonTM, et al. Randomized, placebo-controlled phase 2 trial of a Lactobacillus crispatus probiotic given intravaginally for prevention of recurrent urinary tract infection. Clin Infect Dis2011; 52: 1212–1217.
25.
BeerepootMAter RietGNysS, et al. Lactobacilli vs antibiotics to prevent urinary tract infections: a randomized, double-blind, noninferiority trial in postmenopausal women. Arch Intern Med2012; 172: 704–712.
26.
SchwengerEMTejaniAMLoewenPS.Probiotics for preventing urinary tract infections in adults and children. Cochrane Database Syst Rev2015; (12): CD008772.
27.
PerrottaCAznarMMejiaR, et al. Oestrogens for preventing recurrent urinary tract infection in postmenopausal women. Obstet Gynecol2008; 112: 689–690.
28.
RazR.Hormone replacement therapy or prophylaxis in postmenopausal women with recurrent urinary tract infection. J Infect Dis2001; 183 (Suppl. 1): S74–S76.
29.
CardozoLLoseGMcClishD, et al. A systematic review of estrogens for recurrent urinary tract infections: third report of the hormones and urogenital therapy (HUT) committee. Int Urogynecol J Pelvic Floor Dysfunct2001; 12: 15–20.
30.
SoodRFaubionSSKuhleCL, et al. Prescribing menopausal hormone therapy: an evidence-based approach. Int J Womens Health2014; 6: 47–57.
31.
ParsonsCL.Prevention of urinary tract infection by the exogenous glycosaminoglycan sodium pentosanpolysulfate. J Urol1982; 127: 167–169.
CianiOArendsenERomancikM, et al. Intravesical administration of combined hyaluronic acid (HA) and chondroitin sulfate (CS) for the treatment of female recurrent urinary tract infections: a European multicentre nested case-control study. BMJ Open2016; 6: e009669.
34.
De VitaDGiordanoS. Effectiveness of intravesical hyaluronic acid/chondroitin sulfate in recurrent bacterial cystitis: a randomized study. Int Urogynecol J2012; 23: 1707–1713.
35.
TorellaMSchettinoMTSalvatoreS, et al. Intravesical therapy in recurrent cystitis: a multi-center experience. J Infect Chemother2013; 19: 920–925.
36.
DamianoRQuartoGBavaI, et al. Prevention of recurrent urinary tract infections by intravesical administration of hyaluronic acid and chondroitin sulphate: a placebo-controlled randomised trial. Eur Urol2011; 59: 645–651.
37.
HolmgrenJCzerkinskyC.Mucosal immunity and vaccines. Nat Med2005; 11 (4 Suppl.): S45–S53.
38.
BeerepootMAGeerlingsSEvan HaarstEP, et al. Nonantibiotic prophylaxis for recurrent urinary tract infections: a systematic review and meta-analysis of randomized controlled trials. J Urol2013; 190: 1981–1989.
39.
CuburuNKweonMNSongJH, et al. Sublingual immunization induces broad-based systemic and mucosal immune responses in mice. Vaccine2007; 25: 8598–8610.
40.
TammenH.Immunobiotherapy with Uro-Vaxom in recurrent urinary tract infection. The German Urinary Tract Infection Study Group. Br J Urol1990; 65: 6–9.
41.
SchulmanCCCorbusierAMichielsH, et al. Oral immunotherapy of recurrent urinary tract infections: a double-blind placebo-controlled multicenter study. J Urol1993; 150: 917–921.
42.
MagasiPPanovicsJIllesA, et al. Uro-Vaxom and the management of recurrent urinary tract infection in adults: a randomized multicenter double-blind trial. Eur Urol1994; 26: 137–140.
43.
BauerHWAlloussiSEggerG, et al. A long-term, multicenter, double-blind study of an Escherichia coli extract (OM-89) in female patients with recurrent urinary tract infections. Eur Urol2005; 47: 542–548; discussion 8.
44.
WagenlehnerFMBallariniSPilatzA, et al. A randomized, double-blind, parallel-group, multicenter clinical study of Escherichia coli-lyophilized lysate for the prophylaxis of recurrent uncomplicated urinary tract infections. Urol Int2015; 95: 167–176.
45.
Lorenzo-GomezMFPadilla-FernandezBGarcia-CenadorMB, et al. Comparison of sublingual therapeutic vaccine with antibiotics for the prophylaxis of recurrent urinary tract infections. Front Cell Infect Microbiol2015; 5: 50.
46.
Lorenzo-GomezMFPadilla-FernandezBGarcia-CriadoFJ, et al. Evaluation of a therapeutic vaccine for the prevention of recurrent urinary tract infections versus prophylactic treatment with antibiotics. Int Urogynecol J2013; 24: 127–134.
47.
YangBFoleyS.First experience in the UK of treating women with recurrent urinary tract infections with the bacterial vaccine Uromune((R)). BJU Int2018; 121: 289–292.
