HealthDay News — Various nonantibiotic prophylaxis options are available for urinary tract infections, some of which may be beneficial for adults with recurrent episodes, according to a review and meta-analysis published in the December issue of The Journal of Urology.
Mariëlle A.J. Beerepoot, MD, from the Academic Medical Center in Amsterdam, and colleagues reviewed the literature to assess the effectiveness, tolerability, and safety of nonantibiotic prophylaxis in adults with recurrent urinary tract infections. Data were included from 17 studies for 2,165 patients.
Use of the oral immunostimulant OM-89 decreased UTI recurrence in four trials (risk ratio, 0.61) and has a good safety profile, the researchers found. Another option is the vaginal vaccine Urovac, which slightly reduced the risk of recurrence in three trials (relative risk, 0.81). The time to reinfection was increased with primary immunization followed by booster immunization.
A trend toward preventing urinary tract infections was observed in two trials involving vaginal estrogens (relative risk, 0.42; 95% CI: 0.16-1.10), but in 6% to 20% of women, vaginal irritation occurred. Recurrence was also decreased with cranberries (two trials; relative risk, 0.53) and acupuncture (two open-label trials; relative risk, 0.48).
Oral estrogens and lactobacilli prophylaxis did not reduce recurrence.
“The evidence of the effectiveness of the oral immunostimulant OM-89 is promising,” the researchers wrote. “Large head-to-head trials should be performed to optimally inform clinical decision making.”