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The role of nutraceuticals and phytotherapy in the management of urinary tract infections: What we need to know?

Tommaso Cai, Irene Tamanini, Ekaterina Kulchavenya, Tamara Perepanova, Béla Köves, Florian M.E. Wagenlehner, Zafer Tandogdu, Gernot Bonkat, Riccardo Bartoletti, Truls E. Bjerklund Johansen
  • Irene Tamanini
    Department of Urology, Santa Chiara Regional Hospital, Trento, Italy
  • Ekaterina Kulchavenya
    TB Research Institute, Medical University, Novosibirsk, Russian Federation
  • Tamara Perepanova
    N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Russian Federation
  • Béla Köves
    Jahn Ferenc South Pest Teaching Hospital, Budapest, Hungary
  • Florian M.E. Wagenlehner
    Klinik und Poliklinik für Urologie, Kinderurologie und Andrologie, Universitätsklinikum Giessen und Marburg GmbH, Justus-Liebig-Universität, Giessen, Germany
  • Zafer Tandogdu
    Northern Institute for Cancer Research, Newcastle University, NE1 7RU Newcastle upon-Tyne, United Kingdom
  • Gernot Bonkat
    Alta uro AG, Merian Iselin Klinik, Center of Biomechanics & Calorimetry (COB), University Basel, Basel, Switzerland
  • Riccardo Bartoletti
    Department Translational Research and New Technologies, University of Pisa, Pisa, Italy
  • Truls E. Bjerklund Johansen
    Oslo University Hospital and Univeristy of Oslo, Oslo, Norway


Urinary Tract Infections (UTIs) are amongst the most common infectious diseases and carry a significant impact on patient quality of life and health care costs. Despite that, there is no well-established recommendation for a “standard” prophylactic antibiotic management to prevent UTI recurrences. The majority of patients undergoes long-term antibiotic treatment that severely impairs the normal microbiota and increases the risk of development of multidrugresistant microorganisms. In this scenario, the use of phytotherapy to both alleviate symptoms related to UTI and decrease the rate of symptomatic recurrences is an attractive alternative. Several recently published papers report conflicting findings and cannot give confident recommendations for the everyday clinical practice. A new approach to the management of patients with recurrent UTI might be to use nutraceuticals or phytotherapy after an accurate assessment of the patient`s risk factors. No single compound or mixture has been identified so far as the best preventive approach in patients with recurrent UTI. We reviewed our non-antibiotic approach to the management of recurrent UTI patients in order to clarify the evidence-base for the commonly used substances, understand their pharmacokinetics and pharmacodynamics in order to tailor the best way to improve patient’s quality of life and reduce the rate of antibiotic resistance. Lack of a gold-standard recommendation and the risk of increasing antibiotic resistance is the reason why we need alternatives to antibiotics in the management of urinary tract infections (UTIs). A tailored approach according to bacterial characteristics and the patient risk factors profile is a promising option.


Nutraceuticals; Phytotherapy; Urinary tract infections

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Submitted: 2017-01-13 18:47:02
Published: 2017-03-31 00:00:00
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Copyright (c) 2017 Tommaso Cai, Irene Tamanini, Ekaterina Kulchavenya, Franck Bruyere, Tamara Perepanova, Bela Köves, Adrian Pilatz, Gernot Bonkat, Zafer Tandogdu, Riccardo Bartoletti, Truls E Bjerklund Johansen, Florian Wagenlehner

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