Vaginal and/or oral probiotics reduced recurrent urinary tract infections

Reviewed by Sara Karaba, MD, PhD, MHS, Johns Hopkins University

Bottom line: Vaginal probiotics with or without oral probiotics may be an effective strategy to reduce recurrent urinary tract infections (UTIs) in pre-menopausal women.

Gupta et al published a randomized controlled trial from a single center in India evaluating the use of oral (lactic acid bacteria and bifidobacterial) and/or vaginal (lactobacilli) probiotics among 174 premenopausal women with recurrent UTIs. They found that the mean number of symptomatic UTI recurrences at 4 months was lower among those who received oral placebo and vaginal lactobacilli (1.06) or oral and vaginal probiotics (1.07) compared with oral and vaginal placebo (2.1) and oral probiotic with vaginal placebo (1.63). Time to first symptomatic UTI was also higher among the groups that received vaginal probiotics with or without oral probiotics. The authors also showed the composition of the vaginal microbiome changed with vaginal and/or oral probiotics. Limitations include a small sample size, a large portion of patients were excluded (174 of 328 enrolled), information on the contraception required to participate in the study was not provided, and postmenopausal women were not included. Although it is not clear whether vaginal probiotic products will become available (and whether all products behave similarly), this study provides data suggesting that for UTIs, the vaginal microbiome matters.

Gupta V, Mastromarino P, Garg R. Effectiveness of Prophylactic Oral and/or Vaginal Probiotic Supplementation in the Prevention of Recurrent Urinary Tract Infections: A Randomized, Double-Blind, Placebo-Controlled Trial. Clin Infect Dis 2024; 78:1154–1161.

We use cookies to help improve your experience