Probiotics for UTI Prevention: Can it Help?

Urinary tract infections (UTIs) are common infections that happen in the urinary tract. Some patients might develop a recurrent UTI — a type of UTI that happens at least twice in six months or thrice in a year. Researchers are exploring whether probiotics could be used to treat or prevent UTIs.

What is UTI (urinary tract infection)?

Urinary tract infection (UTI) is an umbrella term for various infections that happen in the urinary tract organs: bladder, urethra, ureters, and kidneys.

Most commonly, UTIs happen in the bladder or urethra. Although these types of UTIs are not life-threatening, they can lead to general discomfort and may spread to other organs if left untreated.

Infections of the kidneys or ureters could potentially lead to urosepsis, therefore it is always important to contact your healthcare provider if you think you have a UTI.

Women are at a greater risk for UTIs but men can be affected as well. It is estimated that about 10–12 in 25 women will develop symptoms of UTI during their lifetime whereas the number for men is around 3 in 25.

Causes of a UTI

Any organ in the urinary system can be implicated in UTI. There are many possible causes for these infections but most of the time it is caused by bacteria, E. coli in particular.

E. coli is a bacterium that typically lives in our intestines. If it reaches and enters the urethra (the tube that lets the urine out of the body), it may cause a UTI. Since the urethra in women's body is closer to their anus than men's, they are at a higher risk for UTIs.

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In most cases, it is hard to pinpoint how exactly bacteria entered the urethra. It is advised to wipe from front to back after using the bathroom, take showers instead of baths, and empty your bladder after sexual intercourse to prevent UTIs.

Most common symptoms

UTIs can cause a wide range of symptoms and can vary to the site of infection. The most commonly reported symptoms are these:

• Frequent urination. A UTI can increase the urge to urinate which does not go away after using the restroom. It is reported that people with UTIs may pass less urine than usual.
• Burning sensation when urinating. The sensation may not go away after emptying the bladder.
• Red or brown discoloration of urine. The red color of urine could be a signal of blood in urine.
• Pain in the abdomen. Most commonly, the pain associated with UTIs can be felt in the lower abdomen.

It is important to contact your healthcare provider if you have a UTI. If you have more severe symptoms such as high fever, shaking, nausea, or vomiting, you may need urgent help.

Probiotics for UTI prevention: does it work?

In most cases, UTIs are treated with antibiotics. Unfortunately, many patients may develop recurrent UTIs and might require daily low doses of antibiotics. Due to increasing concerns about bacterial resistance to antibiotics, scientists are wondering if there could be another way to help patients with UTIs.

UTI's recurrent nature suggests that antibiotics are either not efficiently eliminating pathogenic strains or antibiotic use causes a disbalance of urinary microbiota, thus increasing the susceptibility to future infections. It has been postulated that probiotics may help to overcome these obstacles in antibiotic treatment and reduce the prevalence and recurrence of UTIs.

Some clinical studies tried to test whether probiotics could be effective in preventing UTIs. Unfortunately, current research data does not show any significant effects of using probiotics for UTI prevention. Therefore, as for now, they are not being recommended for UTI management.

Why do probiotics for UTI show no clinical effects?

Multiple clinical studies have looked at the use of probiotics to prevent UTIs. While the majority of them report insignificant changes in UTI prevalence, researchers are still not keen to drop this hypothesis, as there could be several reasons why probiotic usage in these studies did not show sufficient positive outcomes.

Small and low-quality studies

The existing clinical studies on probiotic efficacy for UTI prevention have been limited in both size and quality. Consequently, determining the significance of the benefits and harms associated with these interventions for larger groups of people is challenging. This difficulty may also arise from poor study design, coincidental findings, and other factors.

Not enough studies

The lack of an adequate number of studies investigating the effects of probiotics for UTI prevention complicates the estimation of their significance and potential impact on a wider population.

Ineffective current administration methods

All clinical studies focusing on UTI prevention used either oral probiotics or vaginal probiotic suppositories.

Due to certain formulation aspects, it is difficult for oral probiotics to reach and enter the urinary tract successfully, and thus they may have no impact on UTIs. While vaginal suppositories might offer higher chances of efficacy, it might still be difficult for probiotics to reach and enter the urethra.

Hypothetically, perhaps the best probiotics for UTI could be intraurethral — when the active molecules are delivered through the urethra directly. However, currently, the selection of agents delivered this way is still limited and there are no intraurethral probiotic formulations available.

Should you use probiotics for UTI?

Although the current clinical data suggests that probiotics can not treat or prevent UTIs, overall, probiotics may be taken with antibiotics to reduce their side effects and protect the gut microbiome.

As most UTI cases are caused by bacteria, antibiotics are often employed to treat these infections. As antibiotics may kill both pathogenic and “good” bacteria, probiotic use might be useful in restoring healthy microflora. Studies have shown that probiotics could reduce the risk of some associated complications from antibiotic use, such as antibiotic-associated diarrhea.

Can I take probiotics for UTI while pregnant or breastfeeding?

Currently, there is no clinical research that tested probiotics for UTI for women who are pregnant or breastfeeding. Before using a probiotic for any reason (adjunctive therapy for UTI or general health) it is advisable to consult with your healthcare provider.

Can children take probiotics to reduce the risk of UTI?

Current clinical evidence does not confirm the hypothesis that probiotic administration can be associated with a reduced risk of UTI in children. While there is some evidence that suggests that probiotic therapy paired with antibiotics may increase the efficacy of antibiotics in preventing the incidence of UTI, the use of probiotics in this case should be discussed with your healthcare practitioner.

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