L-Methionine associated with Hibiscus sabdariffa and Boswellia serrata extracts are not inferior to antibiotic treatment for symptoms relief in patients affected by recurrent uncomplicated urinary tract infections: Focus on antibiotic-sparing approach

  • Tommaso Cai | ktommy@libero.it Department of Urology, Santa Chiara Regional Hospital, Trento, Italy.
  • Andrea Cocci Department of Urology, University of Florence, Florence, Italy.
  • Daniele Tiscione Department of Urology, Santa Chiara Regional Hospital, Trento, Italy.
  • Marco Puglisi Department of Urology, Santa Chiara Regional Hospital, Trento, Italy.
  • Fabrizio Di Maida Department of Urology, University of Florence, Florence, Italy.
  • Gianni Malossini Department of Urology, Santa Chiara Regional Hospital, Trento, Italy.
  • Paolo Verze Department of Urology, University of Naples, Federico II, Naples, Italy.
  • Alessandro Palmieri Department of Urology, University of Naples, Federico II, Naples, Italy.
  • Vincenzo Mirone Department of Urology, University of Naples, Federico II, Naples, Italy.
  • Truls E. Bjerklund Johansen Department of Urology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Abstract

Objective: To evaluate the efficacy of a phytotherapic combination of L-Methionine associated with Hibiscus sabdariffa and Boswellia serrata for treatment of acute episodes of uncomplicated urinary tract infections (UTI) in women affected by recurrent UTIs.
Materials and methods: In this randomized phase III clinical trial, adult females with uncomplicated UTI were enrolled into one of the following treatment groups: Group A: phytotherapic combination 1 tablet in the morning and 1 tablet in the evening for 7 days; Group B: Short term antibiotic treatment according to international guidelines recommendations. At baseline, all patients were evaluated by a urologist and quality of life (QoL) questionnaires and mid-stream urine culture. Same clinical and laboratory investigations were repeated at each follow-up visit.
Results: Forty-six patients were enrolled in Group A and 47 in Group B. At the first follow-up (30 days), both groups showed a statistically significant improvement in quality of life scores as compared with baseline assessment [Group A: (QoL 94.3 VS 98.5 p < 0.001); Group B: (QoL 94.5 VS 98.7 p < 0.001)]. An improvement from baseline was also seen at the second followup evaluation after 3 months [Group A: (QoL 94.3 VS 99.1 p < 0.001); Group B: (QoL 94.5 VS 98.1 p < 0.001)]. At the second follow-up visit, a statistically significant difference in QoL was reported between the two groups (99.1 VS 98.1; p < 0.003) and a transition from UTI to asymptomatic bacteriuria (ABU) was observed 12 of 46 (26%) patients in Group A, while no patients in Group B demonstrated ABU (p = 0.007).
Conclusions: Here, we demonstrated that this phytotherapic combination is able, in comparison to antibiotic treatment, to improve patients quality of life, reducing symptoms in acute setting and preventing the recurrences. Interestingly, a significantly higher proportion of patients in the phytotherapy group had ABU after three months. Our findings are of great interest in an antibiotic stewardship perspective.

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Published
2018-06-30
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Section
Original Papers - Stones and Infections
Keywords:
Urinary tract infection, L-Methionine, Hibiscus sabdariffa, Boswellia serrata, Plant extracts, Antibiotic stewardship, Treatment
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How to Cite
Cai, T., Cocci, A., Tiscione, D., Puglisi, M., Di Maida, F., Malossini, G., Verze, P., Palmieri, A., Mirone, V., & Bjerklund Johansen, T. E. (2018). L-Methionine associated with Hibiscus sabdariffa and Boswellia serrata extracts are not inferior to antibiotic treatment for symptoms relief in patients affected by recurrent uncomplicated urinary tract infections: Focus on antibiotic-sparing approach. Archivio Italiano Di Urologia E Andrologia, 90(2), 97-100. https://doi.org/10.4081/aiua.2018.2.97

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