Randomized, Placebo-Controlled Phase 2 Trial of a Lactobacillus crispatus Probiotic Given Intravaginally for Prevention of Recurrent Urinary Tract Infection
~ Source: Clinical Infectious Diseases, April 14, 2011
By Ann E. Stapleton et al.
Abstract
Background: Urinary tract infections (UTIs) are common among women and frequently recur. Depletion of vaginal lactobacilli is associated with UTI risk, which suggests that repletion may be beneficial. We conducted a double-blind placebo-controlled trial of a Lactobacillus crispatusintravaginal suppository probiotic (Lactin-V; Osel) for prevention of recurrent UTI in premenopausal women.
Methods: One hundred young women with a history of recurrent UTI received antimicrobials for acute UTI and then were randomized to receive either Lactin-V or placebo daily for 5 days, then once weekly for 10 weeks. Participants were followed up at 1 week and 10 weeks after intervention and for UTIs; urine samples for culture and vaginal swabs for real-time quantitative 16S ribosomal RNA gene polymerase chain reaction for L.crispatus were collected.
Results: Recurrent UTI occurred in 7/48 15% of women receiving Lactin-V compared with 13/48 27% of women receiving placebo (relative risk [RR], .5; 95% confidence interval, .2–1.2). High-level vaginal colonization with L. crispatus (106 16S RNA gene copies per swab) throughout follow-up was associated with a significant reduction in recurrent UTI only for Lactin-V (RR for Lactin-V, .07; RR for placebo, 1.1; P < .01).
Conclusions: Lactin-V after treatment for cystitis is associated with a reduction in recurrent UTI. Larger efficacy trials of this novel preventive method for recurrent UTI are warranted.
Source: Clinical Infectious Diseases, 2011; DOI: 10.1093/cid/cir183. Ann E. Stapleton, Department of Medicine, University of Washington; Melissa Au-Yeung,Department of Medicine, University of Washington; Thomas M. Hooton, Department of Medicine, University of Miami, Miami, Florida; David N. Fredricks, Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Pacita L. Roberts, Department of Medicine, University of Washington; Christopher A. Czaja, Department of Medicine, National Jewish Health, Denver, Colorado; Yuliya Yarova-Yarovaya, Department of Medicine, University of Washington; Tina Fiedler, Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Marsha Cox, Department of Medicine, University of Washington; Walter E. Stamm, Department of Medicine, University of Washington.
