Probiotics for urinary tract infections
The urinary tract has long been thought to be sterile. However, research in the last decade has established that there is an urinary tract microbiome (urobiome) (1). Urinary tract infections (UTIs) are among the most common infections, affecting especially women. In fact, UTIs are so common, that in the US one in three women under the age of 24 has received antibiotics for UTIs (1). Recurrence rates are as high as 30% within six months. The high use of antibiotics leads to development of antibiotics resistance and can alter the composition of both gut and urobiomes, increasing the risk of recurrence and other infections (1,2).
Women in particular often suffer from UTIs and both the so-called gut-bladder and vagina-bladder axes play a role, because both the gut and vaginal microbiomes can be sources of pathogens causing UTIs (2). Ensuring that these two microbiomes are healthy is key in the prevention of overgrowth of opportunistic pathogens that can cause UTIs. Clinical studies indeed show that specific oral and vaginal probiotics can reduce the risk of UTIs (2).
While treatment of the gut microbiome is becoming more familiar and fecal analyses can help to detect potential pathogens that can targeted via personalized microbiome treatments, the vaginal microbiome is less well-know. Contrary to the gut microbiome, a healthy vaginal microbiome is associated with a very low diversity, while a high vaginal microbiome diversity is associated with dysbiosis and pathogen overgrowth (3). A vaginal microbiome that is dominated by Lactobacilli (most notably Lactobacillus crispatus) is considered healthy and can inhibit growth of UTI-pathogens such as E. coli (4). A RCT with a vaginally administered probiotic containing a L. crispatus strain showed reduced risk for recurring UTIs, in particular when the probiotic strain colonized the vaginal microbiome (5). That is why the magistrally prepared vaginal suppositories developed by Microbiome Center together with our pharmacist contain two different L. crispatus strains.
Depending on the presence of dysbiosis in the gut or vagina, you can treat your patients with UTIs either with personalized gut microbiome treatment and/or vaginal suppositories. The personalized gut microbiome treatment can be prescribed via the Advice Aid on our platform, whereas the vaginal suppositories can be prescribed directly via the “New” prescription button and then selecting the “Magistral product” category at the top.
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