Bladder Infections – Natural Treatments for UTIs
Urinary tract infections (UTIs) are the second most common infection among adults and account for more than 8 million visits to health care practitioners each year1. The bacteria Escherichia coli cause most UTIs, but other bacteria can also cause the infection (Table 1). Antibiotic drugs are routinely prescribed for bladder infections. However, there are side-effects associated with the use of antibiotics and their overuse leads to the emergence of drug-resistant bacteria. Therefore, effective alternatives to antibiotic drugs are needed. The following natural treatments for UTIs can be used in conjunction with antibiotics and may offer a safe alternative to antibiotics for many sufferers of UTIs.
Caution: Always consult your healthcare provider if your UTI is associated with serious symptoms (e.g., fever, back pain, significant blood in the urine) or if the infection persists for more than a few days without improvement.
Table 1. Most common bacteria causing UTI 2,3
1. Drink More Water
One of the simplest natural treatments for UTIs is to drink more water. People who drink less than 1 L of water per day are about 7% more likely to experience UTIs, compared to those who drink more than 1 L of water per day5. Furthermore, increasing water intake alone decreases the risk of primary UTIs by 45%4.
How does drinking more water work?
In general, stagnant water is a breeding ground for bugs and bacteria. This fact generalizes to the urinary tract. Drinking more water increases the volume of urine and frequency of voiding; it helps to “flush out” the bacteria that cause UTIs. A recent study showed that increasing water intake deprives bacteria of adequate nutrition and reduces their growth6.
How much water should I drink?
Although no research studies have determined the optimal amount of water to prevent UTIs, consuming at least 2-3 L of water per day should be sufficient. More water may be required if you are in a hot climate and losing water through sweating. Make sure your urine is pale yellow or almost clear. The darker the urine, the more dehydrated you are.
2. Bearberry – The Urinary Antiseptic
Long before the advent of antibiotics, a small bush called bearberry was used for centuries as a natural treatment for UTIs. Herbalists use bearberry leaves as a urinary antiseptic to treat bladder and sexually transmitted infections7. Research shows bearberry is effective in inhibiting the growth of two bacteria (Escherichia coli and Enterococcus faecalis) that cause UTIs.
How does bearberry work?
Bearberry contains arbutin which is a toxic hydroquinone molecule attached to a sugar. The addition of the sugar to hydroquinone forms the molecule arbutin, and the sugar helps to stabilize hydroquinone. Arbutin acts like a “trap” for some bacteria: the sugar attracts the bacteria and when the bacteria digest the sugar, they release the toxic hydroquinone that generates free radicals and disrupts cell membranes. The bacteria Enterococcus faecalis8 and E. coli9 appear to be susceptible to arbutin, but not all bacteria are vulnerable. Therefore, bearberry will not work for all types of infections.
How do I take bearberry?
The active ingredients dissolve in water and alcohol so both teas and tinctures can be used.
- Tincture: 2-4 mL three times per day.
- Tea (dried herb): three times per day
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Caution: Bearberry is considered safe when used as indicated10. However, it should be avoided during lactation and pregnancy because its safety has not been established. Also, it should not be used for more than 1-2 months because arbutin releases hydroquinone in the acidic environment of the stomach and, in theory, could increase the risk of stomach cancer.
3. Cranberries – The Anti-Adhesive Herb
Cranberry juice is probably the most well-known home remedy for bladder infections. Research suggests its use may benefit people suffering from UTIs caused by E. coli 11,12, Enterococcus faecalis 13, Pseudomonas aeruginosa 14,15, and Proteus mirabilis 12,16,17.
How do cranberries work?
Cranberries inhibit the enzymatic activity11,13 and motility of certain bacteria16,18,19. In particular, cranberries exert anti-adhesive effects20–22 and prevent certain bacteria from attaching to the cells of the urinary tract. Both sugars 23–26 (e.g., mannose) and phenolic compounds29–31, especially the anthocyanidins, contribute to the anti-adhesive effects. Furthermore, the anthocyanidins are reported to limit nutrients for bacteria, leading to growth inhibition27,28.
Cranberries in different forms are beneficial in preventing the occurrence and recurrence of UTIs in various populations32–40. Cranberries reduced urinary tract infections after surgery by roughly 50%41, even among patients with catheters42. Cranberry juice is also effective in preventing UTIs after renal transplantation43. Antibiotics may also be used for the prevention of UTIs, however, a recent study showed that certain antibiotics have very little advantage over cranberry extracts and those using antibiotics are more prone to adverse effects44.
Note: some studies failed to show cranberry’s effectiveness in preventing UTIs 27,45–51. This could be explained by too low a dose of cranberry anthocyanidins and that some bacteria may not be susceptible to cranberry extract.
How do I take cranberries?
Cranberries can be consumed as the fruit, pills/capsules, powder, or juice. It is important that an extract contains a high concentration of the anthocyanidins.
- Unsweetened cranberry juice: 120-240 mL/day32
- Capsules: 2 caps/day (containing 36 mg of anthocyanidins)
- Cranberry fruit powder (500 mg/day) 37
- Dried cranberry: 42 mg/day 34
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Note: When taking a cranberry supplement be certain to purchase from a reputable company that standardizes the product. A recent survey showed certain berry products (including cranberries) did not contain the desired herb and/or the dose of the anthocyanin was variable52.
4. Goldenseal – The Natural Antibiotic
Goldenseal has a long history of use in herbal medicine as a natural antibiotic. It is used primarily for respiratory and digestive infections but it is also used as a natural treatment for UTIs and sexually transmitted infections 53.
How does goldenseal work?
Goldenseal contains several antibacterial compounds, including berberine and hydrastine, that disrupt DNA synthesis in bacteria thus inhibiting their growth54. In addition, goldenseal contains other phytochemicals that inhibit drug resistance. Studies demonstrate that goldenseal and/or berberine have activity against several bacteria that cause UTIs including Escherichia coli55, Enterococcus faecalis56, Chlamydia57, Neisseria gonorrhea58.
How do I take goldenseal?
The active compounds in goldenseal are soluble is alcohol but only sparingly soluble in water. Therefore alcohol extracts, called tinctures, are the best way to take it.
- Tincture (1:5 60% Alcohol): 1 mL 3 times a day
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D-Mannose is a unique sugar found in small amounts in certain fruits, including cranberries and apples. Human studies demonstrate that D-mannose powder reduces the risk of recurrent UTIs59,60. Moreover, it reduces UTI symptoms including bladder pain and urinary urgency.
How does D-Mannose work?
Like cranberries, D-mannose has anti-adhesive properties. D-mannose reduces infection by Escherichia coli by preventing attachment of the bacteria to cells of the urinary tract61,62. The surfaces of urinary cells have receptors with mannose sugars attached. Bacteria must attach to these receptors before they can infect the cells. D-mannose prevents attachment by covering the “hands” of the bacteria so they can not grab a hold of the urinary tract and therefore are flushed out with the urine.
How do I take D-mannose?
- D-mannose (powder): 2-3 g/day dissolved in 200 mL water61,62.
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Juniper berries have long been used as a flavouring in food and drink, including gin. Herbalists use the berries for digestive and urinary issues. In particular, juniper is used as one of the natural treatments for UTIs and also sexually transmitted infection.
How does juniper work?
Juniper berries are rich in essential oils, including terpinen-4-ol, that demonstrate broad spectrum anti-bacterial activity63. These essential oils enhance the effects of antibiotics63. Furthermore, juniper acts as a diuretic to increase urine production and may help flush of the bacteria64.
How do I take juniper?
Essential oils are soluble in alcohol and thus herbal tinctures are appropriate:
- Tincture (1:5 in 40% EtOH): 0.5-1 mL three times a day.
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Probiotics should be considered a useful and safe alternative to antibiotics for preventing UTIs65. Limited studies are available 66,67 but results show that prophylactic probiotic supplementation could reduce the development of kidney infections in children68,69. Probiotics also reduce UTIs in patients after surgery 70. Moreover, research with children shows the addition of probiotics to prophylactic antibiotics treatment is safe and more effective in reducing the incidence of serious UTIs in comparison to antibiotics alone71,72.
How do probiotics work to prevent UTIs?
Probiotics are “good bacteria” that are used to support the digestive tract. They are different than other natural treatments for UTIs because they are living organisms that improve the gut flora. The bacteria that cause urinary tract infection usually reside in the bowels and typically migrate to the urinary tract and cause infection. Probiotics (e.g., Lactobacilli) release chemicals (lactic acid) that inhibit the growth of disease-causing bacteria 73 and thus prevent infecton74.
How do I take probiotics?
Probiotics alone are not an effective natural treatment for UTIs but can be taken long-term to prevent UTIs. Probiotics are available in both capsules and powders. The precise strains and amount of probiotics have not been determined. Presumably, 30-50 billion CFU mixed strains with Lactobacilli should suffice.
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8. Vitamin D
Although Vitamin D is usually associated with strong bones, it some cased it may help prevent UTIs. Vitamin D deficiency increases the risk of UTIs in various populations75–77. This led to present research to determine if vitamin D supplementation will lead to a decrease in UTI occurrence and recurrence 78.
How does Vitamin D work?
A peptide known as cathelicidin is an important antimicrobial peptide found in the urinary tract. Several studies have shown that vitamin D stimulates cathelicidin expression, thus preventing urinary tract infection in vitro 79. But this was not evident among humans80,81. Furthermore, vitamin D modulates the immune system 82 to fight off infections caused by Escherichia coli83. The occurrence of UTIs was found to be lower among those who take vitamin D81. On contrary, vitamin D supplementation increases the risk of UTIs in infants less than 3 months of age84.
How do I take Vitamin D?
Research suggests an intake of 20,000 IU per week of vitamin D3 was found to reduce the occurrence of UTI in adults.
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Summary of Natural Treatments for UTIs
Natural treatments for UTIs can work by different mechanisms. Drinking more water, taking diuretic herbs (e.g., juniper and bearberry) and anti-adherence therapies (e.g., cranberry and mannose) help flush bacteria from the urinary tract. Urinary antiseptics (e.g., bearberry and juniper) and natural antibiotics (e.g., goldenseal) compromise bacterial membranes and inhibit bacterial enzymes respectively, thereby inhibiting bacterial growth. Probiotics compete with pathogenic bacteria to reduce the colonization of disease causing bacteria in the gut. Finally, vitamin D appears to boost the immune system to help the body to fight off infections. In summary, employing multiple natural treatments for UTIs that work by different mechanisms may be the best strategy to both prevent and treat bladder infections.
Author & Photographer: Matt Gowan, BSc, ND
All images are copyright of Matt Gowan ©2017
Disclaimer: This content is subject to change. The information is intended to inform and educate; it does not replace the medical evaluation, advice, diagnosis or treatment by a healthcare professional. www.nhpassist.com © 2017 NDAssist Inc. and/or its affiliates. All rights reserved.
Schappert S, Rechtsteiner E. Ambulatory medical care utilization estimates for 2006. Natl Health Stat Report
. 2008;(8):1-29. [PubMed]
Kasper D, Jameson J, Hauser S, Loscalzo J, Fauci A, Longo D. Harrison’s Principles of Internal Medicine 19/E (Vol.1 & Vol.2). McGraw-Hill Education / Medical; 2015.
Mazzulli T. Diagnosis and management of simple and complicated urinary tract infections (UTIs). Can J Urol
. 2012;19 Suppl 1:42-48. [PubMed]
Bruyère F, Buendia-Jiménez I, Cosnefroy A, et al. [Urinary tract infections: Economical impact of water intake]. Prog Urol
. 2015;25(10):590-597. [PubMed]
Zincir H, Kaya E, Ozkan F, Seviğ U, Başer M, Elmalı F. Prevalence of urinary tract infections and its risk factors in elementary school students. Urol Int
. 2012;88(2):194-197. [PubMed]
Tian Y, Cai X, Wazir R, Wang K, Li H. Water consumption and urinary tract infections: an in vitro study. Int Urol Nephrol
. 2016;48(6):949-954. [PubMed]
King J, Felter H Wickes. King’s American Dispensatory (Originally Published: 1898). Vol 1. Arkose Press; 2015.
Cai T, Gallelli L, Meacci F, et al. The Efficacy of Umbelliferone, Arbutin, and N-Acetylcysteine to Prevent Microbial Colonization and Biofilm Development on Urinary Catheter Surface: Results from a Preliminary Study. J Pathog
. 2016;2016:1590952. [PubMed]
Siegers C, Bodinet C, Ali S, Siegers C. Bacterial deconjugation of arbutin by Escherichia coli. Phytomedicine
. 2003;10 Suppl 4:58-60. [PubMed]
de A, Naser B, Nolte K. Risk assessment of free hydroquinone derived from Arctostaphylos Uva-ursi folium herbal preparations. Int J Toxicol
. 2013;32(6):442-453. [PubMed]
Bukhari S, Chiragh S, Tariq S, Alam M, Wazir M, Suleman M. IN VITRO ACTIVITY OF VACCINIUM MACROCARPON (CRANBERRY) ON URINARY TRACT PATHOGENS IN UNCOMPLICATED URINARY TRACT INFECTION. J Ayub Med Coll Abbottabad
. 2015;27(3):660-663. [PubMed]
Nicolosi D, Tempera G, Genovese C, Furneri P. Anti-Adhesion Activity of A2-type Proanthocyanidins (a Cranberry Major Component) on Uropathogenic E. coli and P. mirabilis Strains. Antibiotics (Basel)
. 2014;3(2):143-154. [PubMed]
Wojnicz D, Tichaczek-Goska D, Korzekwa K, Kicia M, Hendrich A. Study of the impact of cranberry extract on the virulence factors and biofilm formation by Enterococcus faecalis strains isolated from urinary tract infections. Int J Food Sci Nutr
. 2016;67(8):1005-1016. [PubMed]
Ulrey R, Barksdale S, Zhou W, van H. Cranberry proanthocyanidins have anti-biofilm properties against Pseudomonas aeruginosa. BMC Complement Altern Med
. 2014;14:499. [PubMed]
Harjai K, Gupta R, Sehgal H. Attenuation of quorum sensing controlled virulence of Pseudomonas aeruginosa by cranberry. Indian J Med Res
. 2014;139(3):446-453. [PubMed]
McCall J, Hidalgo G, Asadishad B, Tufenkji N. Cranberry impairs selected behaviors essential for virulence in Proteus mirabilis HI4320. Can J Microbiol
. 2013;59(6):430-436. [PubMed]
O’May C, Amzallag O, Bechir K, Tufenkji N. Cranberry derivatives enhance biofilm formation and transiently impair swarming motility of the uropathogen Proteus mirabilis HI4320. Can J Microbiol
. 2016;62(6):464-474. [PubMed]
Hidalgo G, Chan M, Tufenkji N. Inhibition of Escherichia coli CFT073 fliC expression and motility by cranberry materials. Appl Environ Microbiol
. 2011;77(19):6852-6857. [PubMed]
Chan M, Hidalgo G, Asadishad B, et al. Inhibition of bacterial motility and spreading via release of cranberry derived materials from silicone substrates. Colloids Surf B Biointerfaces
. 2013;110:275-280. [PubMed]
Jass J, Reid G. Effect of cranberry drink on bacterial adhesion in vitro and vaginal microbiota in healthy females. Can J Urol
. 2009;16(6):4901-4907. [PubMed]
Chen C, Ho D, Chang P, Lin W, Huang Y. Urine post equivalent daily cranberry juice consumption may opsonize uropathogenicity of Escherichia coli. J Infect Chemother
. 2013;19(5):812-817. [PubMed]
Mathison B, Kimble L, Kaspar K, Khoo C, Chew B. Consumption of cranberry beverage improved endogenous antioxidant status and protected against bacteria adhesion in healthy humans: a randomized controlled trial. Nutr Res
. 2014;34(5):420-427. [PubMed]
Tao Y, Pinzón-Arango P, Howell A, Camesano T. Oral consumption of cranberry juice cocktail inhibits molecular-scale adhesion of clinical uropathogenic Escherichia coli. J Med Food
. 2011;14(7-8):739-745. [PubMed]
Hotchkiss A, Nuñez A, Strahan G, et al. Cranberry Xyloglucan Structure and Inhibition of Escherichia coli Adhesion to Epithelial Cells. J Agric Food Chem
. 2015;63(23):5622-5633. [PubMed]
Rafsanjany N, Senker J, Brandt S, Dobrindt U, Hensel A. In Vivo Consumption of Cranberry Exerts ex Vivo Antiadhesive Activity against FimH-Dominated Uropathogenic Escherichia coli: A Combined in Vivo, ex Vivo, and in Vitro Study of an Extract from Vaccinium macrocarpon. J Agric Food Chem
. 2015;63(40):8804-8818. [PubMed]
Sun J, Marais J, Khoo C, et al. Cranberry (<i>Vaccinium macrocarpon</i>) oligosaccharides decrease biofilm formation by uropathogenic <i>Escherichia coli</i>. J Funct Foods
. 2015;17:235-242. [PubMed]
Barbosa-Cesnik C, Brown M, Buxton M, Zhang L, DeBusscher J, Foxman B. Cranberry juice fails to prevent recurrent urinary tract infection: results from a randomized placebo-controlled trial. Clin Infect Dis
. 2011;52(1):23-30. [PubMed]
Hidalgo G, Ponton A, Fatisson J, et al. Induction of a state of iron limitation in uropathogenic Escherichia coli CFT073 by cranberry-derived proanthocyanidins as revealed by microarray analysis. Appl Environ Microbiol
. 2011;77(4):1532-1535. [PubMed]
Blaim A. [Achievements in social pediatrics]. Pieleg Polozna
. 1979;(6):16-17. [PubMed]
Rodríguez-Pérez C, Quirantes-Piné R, Uberos J, Jiménez-Sánchez C, Peña A, Segura-Carretero A. Antibacterial activity of isolated phenolic compounds from cranberry (Vaccinium macrocarpon) against Escherichia coli. Food Funct
. 2016;7(3):1564-1573. [PubMed]
Gupta P, Song B, Neto C, Camesano T. Atomic force microscopy-guided fractionation reveals the influence of cranberry phytochemicals on adhesion of Escherichia coli. Food Funct
. 2016;7(6):2655-2666. [PubMed]
Takahashi S, Hamasuna R, Yasuda M, et al. A randomized clinical trial to evaluate the preventive effect of cranberry juice (UR65) for patients with recurrent urinary tract infection. J Infect Chemother
. 2013;19(1):112-117. [PubMed]
Sánchez B, Ruiz V, López A, et al. Cysticlean® a highly pac standardized content in the prevention of recurrent urinary tract infections: an observational, prospective cohort study. BMC Urol
. 2013;13:28. [PubMed]
Burleigh A, Benck S, McAchran S, Reed J, Krueger C, Hopkins W. Consumption of sweetened, dried cranberries may reduce urinary tract infection incidence in susceptible women–a modified observational study. Nutr J
. 2013;12(1):139. [PubMed]
Caljouw M, van den, Putter H, Achterberg W, Cools H, Gussekloo J. Effectiveness of cranberry capsules to prevent urinary tract infections in vulnerable older persons: a double-blind randomized placebo-controlled trial in long-term care facilities. J Am Geriatr Soc
. 2014;62(1):103-110. [PubMed]
Ledda A, Bottari A, Luzzi R, et al. Cranberry supplementation in the prevention of non-severe lower urinary tract infections: a pilot study. Eur Rev Med Pharmacol Sci
. 2015;19(1):77-80. [PubMed]
Vostalova J, Vidlar A, Simanek V, et al. Are High Proanthocyanidins Key to Cranberry Efficacy in the Prevention of Recurrent Urinary Tract Infection? Phytother Res
. 2015;29(10):1559-1567. [PubMed]
Maki K, Kaspar K, Khoo C, Derrig L, Schild A, Gupta K. Consumption of a cranberry juice beverage lowered the number of clinical urinary tract infection episodes in women with a recent history of urinary tract infection. Am J Clin Nutr
. 2016;103(6):1434-1442. [PubMed]
Singh I, Gautam L, Kaur I. Effect of oral cranberry extract (standardized proanthocyanidin-A) in patients with recurrent UTI by pathogenic E. coli: a randomized placebo-controlled clinical research study. Int Urol Nephrol
. 2016;48(9):1379-1386. [PubMed]
Wan K, Liu C, Lee W, Ko M, Huang C. Cranberries for Preventing Recurrent Urinary Tract Infections in Uncircumcised Boys. Altern Ther Health Med
. 2016;22(6):20-23. [PubMed]
Foxman B, Cronenwett A, Spino C, Berger M, Morgan D. Cranberry juice capsules and urinary tract infection after surgery: results of a randomized trial. Am J Obstet Gynecol
. 2015;213(2):194.e1-8. [PubMed]
Barnoiu O, Sequeira-García D, Sanchez-Martínez N, Díaz-Molina P, Flores-Sirvent L, Baena-González V. American cranberry (proanthocyanidin 120 mg): its value for the prevention of urinary tracts infections after ureteral catheter placement. Actas Urol Esp
. 2015;39(2):112-117. [PubMed]
Gabriel S, Conn D, Luthra H. Rifampin therapy in rheumatoid arthritis. J Rheumatol
. 1990;17(2):163-166. [PubMed]
McMurdo M, Argo I, Phillips G, Daly F, Davey P. Cranberry or trimethoprim for the prevention of recurrent urinary tract infections? A randomized controlled trial in older women. J Antimicrob Chemother
. 2009;63(2):389-395. [PubMed]
Cadková I, Doudová L, Novácková M, Huvar I, Chmel R. [Effect of cranberry extract capsules taken during the perioperative period upon the post-surgical urinary infection in gynecology]. Ceska Gynekol
. 2009;74(6):454-458. [PubMed]
Salo J, Uhari M, Helminen M, et al. Cranberry juice for the prevention of recurrences of urinary tract infections in children: a randomized placebo-controlled trial. Clin Infect Dis
. 2012;54(3):340-346. [PubMed]
Stapleton A, Dziura J, Hooton T, et al. Recurrent urinary tract infection and urinary Escherichia coli in women ingesting cranberry juice daily: a randomized controlled trial. Mayo Clin Proc
. 2012;87(2):143-150. [PubMed]
Jepson R, Craig J, Williams G. Cranberry products and prevention of urinary tract infections. JAMA
. 2013;310(13):1395-1396. [PubMed]
Gallien P, Amarenco G, Benoit N, et al. Cranberry versus placebo in the prevention of urinary infections in multiple sclerosis: a multicenter, randomized, placebo-controlled, double-blind trial. Mult Scler
. 2014;20(9):1252-1259. [PubMed]
Liska D, Kern H, Maki K. Cranberries and Urinary Tract Infections: How Can the Same Evidence Lead to Conflicting Advice? Adv Nutr
. 2016;7(3):498-506. [PubMed]
Juthani-Mehta M, Van N, Bianco L, et al. Effect of Cranberry Capsules on Bacteriuria Plus Pyuria Among Older Women in Nursing Homes: A Randomized Clinical Trial. JAMA
. 2016;316(18):1879-1887. [PubMed]
Lee J. Anthocyanin analyses of Vaccinium fruit dietary supplements. Food Sci Nutr
. 2016;4(5):742-752. [PubMed]
Peng L, Kang S, Yin Z, et al. Antibacterial activity and mechanism of berberine against Streptococcus agalactiae. Int J Clin Exp Pathol
. 2015;8(5):5217-5223. [PubMed]
Kong W, Xing X, Xiao X, et al. Effect of berberine on Escherichia coli, Bacillus subtilis, and their mixtures as determined by isothermal microcalorimetry. Appl Microbiol Biotechnol
. 2012;96(2):503-510. [PubMed]
Chen L, Bu Q, Xu H, et al. The effect of berberine hydrochloride on Enterococcus faecalis biofilm formation and dispersion in vitro. Microbiol Res
. 2016;186-187:44-51. [PubMed]
Ma L, Zhang L, Wang B, Wei J, Liu J, Zhang L. Berberine inhibits Chlamydia pneumoniae infection-induced vascular smooth muscle cell migration through downregulating MMP3 and MMP9 via PI3K. Eur J Pharmacol
. 2015;755:102-109. [PubMed]
Cybulska P, Thakur S, Foster B, et al. Extracts of Canadian first nations medicinal plants, used as natural products, inhibit neisseria gonorrhoeae isolates with different antibiotic resistance profiles. Sex Transm Dis
. 2011;38(7):667-671. [PubMed]
Kranjčec B, Papeš D, Altarac S. D-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial. World J Urol
. 2014;32(1):79-84. [PubMed]
Schaeffer A, Chmiel J, Duncan J, Falkowski W. Mannose-sensitive adherence of Escherichia coli to epithelial cells from women with recurrent urinary tract infections. J Urol
. 1984;131(5):906-910. [PubMed]
Michaels E, Chmiel J, Plotkin B, Schaeffer A. Effect of D-mannose and D-glucose on Escherichia coli bacteriuria in rats. Urol Res
. 1983;11(2):97-102. [PubMed]
Lahmar A, Bedoui A, Mokdad-Bzeouich I, et al. Reversal of resistance in bacteria underlies synergistic effect of essential oils with conventional antibiotics. Microb Pathog
. 2017;106:50-59. [PubMed]
Stanić G, Samaržija I, Blažević N. Time-dependent diuretic response in rats treated with Juniper berry preparations. Phytotherapy Research. 1998;12(7).
Chisholm A. Probiotics in Preventing Recurrent Urinary Tract Infections in Women: A Literature Review. Urol Nurs
. 2015;35(1):18-21, 29. [PubMed]
Schwenger E, Tejani A, Loewen P. Probiotics for preventing urinary tract infections in adults and children. Cochrane Database Syst Rev
. 2015;(12):CD008772. [PubMed]
Lee B, Toh S, Ryan S, et al. Probiotics [LGG-BB12 or RC14-GR1] versus placebo as prophylaxis for urinary tract infection in persons with spinal cord injury [ProSCIUTTU]: a study protocol for a randomised controlled trial. BMC Urol
. 2016;16:18. [PubMed]
Lee S, Lee J. Probiotics prophylaxis in infants with primary vesicoureteral reflux. Pediatr Nephrol
. 2015;30(4):609-613. [PubMed]
Lee S, Cha J, Lee J. Probiotics prophylaxis in pyelonephritis infants with normal urinary tracts. World J Pediatr
. 2016;12(4):425-429. [PubMed]
Sawas T, Al H, Hernaez R, Carey W, Cho W. Patients Receiving Prebiotics and Probiotics Before Liver Transplantation Develop Fewer Infections Than Controls: A Systematic Review and Meta-Analysis. Clin Gastroenterol Hepatol
. 2015;13(9):1567-74.e3; quiz e143-4. [PubMed]
Mohseni M, Aryan Z, Emamzadeh-Fard S, et al. Combination of probiotics and antibiotics in the prevention of recurrent urinary tract infection in children. Iran J Pediatr
. 2013;23(4):430-438. [PubMed]
Madden-Fuentes R, Arshad M, Ross S, Seed P. Efficacy of Fluoroquinolone/Probiotic Combination Therapy for Recurrent Urinary Tract Infection in Children: A Retrospective Analysis. Clin Ther
. 2015;37(9):2143-2147. [PubMed]
Lim I, Lee H, Kim W. The effect of lactic acid bacteria isolates on the urinary tract pathogens to infants in vitro. J Korean Med Sci
. 2009;24 Suppl:S57-62. [PubMed]
Delley M, Bruttin A, Richard M, Affolter M, Rezzonico E, Brück W. In vitro activity of commercial probiotic Lactobacillus strains against uropathogenic Escherichia coli. FEMS Microbiol Lett
. 2015;362(13):fnv096. [PubMed]
Nseir W, Taha M, Nemarny H, Mograbi J. The association between serum levels of vitamin D and recurrent urinary tract infections in premenopausal women. Int J Infect Dis
. 2013;17(12):e1121-4. [PubMed]
Tekin M, Konca C, Celik V, et al. The Association between Vitamin D Levels and Urinary Tract Infection in Children. Horm Res Paediatr
. 2015;83(3):198-203. [PubMed]
Kwon Y, Kim H, Oh H, et al. Vitamin D deficiency is an independent risk factor for urinary tract infections after renal transplants. Medicine (Baltimore)
. 2015;94(9):e594. [PubMed]
Rodriguez-Sanchez M, Camacho-Palma J, Dominguez-Bellini C, et al. Vitamin D Supplementation for the Prevention of Recurrent Urinary Tract Infection in Women – PROUD: A Randomized Controlled Trial. Principles and Practice of Clinical Research. 2016;2(1).
Hertting O, Holm Å, Lüthje P, et al. Vitamin D induction of the human antimicrobial Peptide cathelicidin in the urinary bladder. PLoS One
. 2010;5(12):e15580. [PubMed]
Övünç H, Altun D, Hacıhamdioğlu B, et al. The Association between Serum 25-Hydroxy Vitamin D Level and Urine Cathelicidin in Children with a Urinary Tract Infection. J Clin Res Pediatr Endocrinol
. 2016;8(3):325-329. [PubMed]
Jorde R, Sollid S, Svartberg J, Joakimsen R, Grimnes G, Hutchinson M. Prevention of urinary tract infections with vitamin D supplementation 20,000 IU per week for five years. Results from an RCT including 511 subjects. Infect Dis (Lond)
. 2016;48(11-12):823-828. [PubMed]
van der, Kenne E, Koppelaar E, Agerberth B, Lindbom L. Vitamin D₃ and phenylbutyrate promote development of a human dendritic cell subset displaying enhanced antimicrobial properties. J Leukoc Biol
. 2014;95(6):883-891. [PubMed]
Ramos N, Sekikubo M, Kironde F, Mirembe F, Sääf M, Brauner A. The impact of vitamin D on the innate immune response to uropathogenic Escherichia coli during pregnancy. Clin Microbiol Infect
. 2015;21(5):482.e1-7. [PubMed]
Katikaneni R, Ponnapakkam T, Ponnapakkam A, Gensure R. Breastfeeding does not protect against urinary tract infection in the first 3 months of life, but vitamin D supplementation increases the risk by 76%. Clin Pediatr (Phila)
. 2009;48(7):750-755. [PubMed]