Using Probiotics as a Preventive Strategy for Recurrent Urinary Tract Infections: Focusing on Patient Engagement and Quality of Care

Urinary tract infections (UTIs) represent one of the most prevalent bacterial infections worldwide, particularly among women. They are usually caused by uropathogenic Escherichia coli and are classified as either complicated or uncomplicated, depending on host factors and the anatomical or functional state of the urinary tract. Increasing antibiotic resistance and recurrence rates have intensified the search for preventive approaches that could reduce antibiotic use and restore microbial balance. Probiotics, defined as live microorganisms that confer a health benefit to the host when administered in adequate amounts, may contribute to urogenital health by supporting the restoration of the natural microbiota and preventing pathogen colonization.

The aim of this research was to investigate the potential of probiotics in preventing UTIs through a structured, systematic literature review. Scientific articles were identified using the PubMed and Cochrane Library databases. Eligible studies were selected based on predefined inclusion criteria and analysed descriptively. The selection process was shown in a PRISMA diagram.

Nine studies met the inclusion criteria, covering diverse populations including children (aged 4 months to 18 years), premenopausal and postmenopausal women, and individuals with spinal cord injuries. The included studies investigated different probiotic strains and formulations, primarily species of the Lactobacillus genus, administered orally or intravaginally.

The results indicate that some probiotic strains show greater potential than others in reducing the recurrence of UTIs. Importantly, probiotic efficacy appears to be strain-specific rather than universal. Many studies tend to generalize probiotic effects as if all strains are equally effective across different conditions. However, expecting all probiotics to prevent UTIs is as unrealistic as expecting all drugs to treat diabetes; it is sufficient that specific strains demonstrate efficacy for defined indications, just as insulin works for diabetes.

In conclusion, probiotics represent a promising complementary strategy for UTI prevention. Further well-designed, large-scale randomized controlled trials are required to identify the most effective strains and the optimal dosage and duration of therapy, as well as to establish evidence-based recommendations for clinical use.