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Recurrent Escherichia coli Urinary Tract Infection Triggered by Gardnerella vaginalis Bladder Exposure in Mice
Published on: December 4, 2020
Probiotic prophylaxis in adult women with recurrent uncomplicated urinary tract infections: A systematic review of
Marcos Yauri-Idelfonso1, Claudia Picón-Rafaelo1, Pedro Rosales-Goñe1
1Facultad de Medicina, Universidad Nacional Hermilio Valdizan, Huánuco, Peru.
Journal of Global Antimicrobial Resistance
|June 26, 2026
Summary
Probiotic use, especially intravaginal Lactobacillus, effectively prevents recurrent urinary tract infections (rUTI) in women. This safe, non-antibiotic approach restores vaginal microbiota and reduces infection recurrence.
Area of Science:
- Microbiology
- Urology
- Infectious Diseases
Background:
- Recurrent urinary tract infections (rUTI) are common in women, with traditional antibiotic prophylaxis driving antimicrobial resistance.
- Probiotics, particularly Lactobacillus strains, offer a non-antibiotic alternative to restore urogenital microbiota.
Purpose of the Study:
- To systematically review the efficacy and safety of probiotic prophylaxis for preventing rUTI in adult women.
- To compare probiotic prophylaxis against placebo or antibiotic prophylaxis.
Main Methods:
- Systematic review following PRISMA guidelines, including randomized controlled trials.
- Searched MEDLINE, EMBASE, CENTRAL, LILACS, and Google Scholar up to December 2025.
- Assessed risk of bias with RoB 2 and certainty of evidence with GRADE, performing narrative synthesis due to heterogeneity.
Main Results:
- Four trials (n=616) showed probiotics reduced rUTI recurrence and increased time to first recurrence compared to placebo.
- Intravaginal Lactobacillus crispatus demonstrated a relative risk of 0.50 (95% CI: 0.20-1.20), with 15% vs. 27% recurrence rates.
- Intravaginal probiotics showed consistent benefit and effective vaginal recolonization; no serious adverse events were reported.
Conclusions:
- Probiotic prophylaxis is a promising, safe strategy for preventing rUTI in women.
- Intravaginal administration offers the greatest clinical benefit.
- Probiotics represent a valuable non-antibiotic alternative to combat antimicrobial resistance.
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