Vaginal mucosal immunization for recurrent urinary tract infection: phase II clinical trial.
OBJECTIVE
Decreased local immunity to uropathogenic bacteria may be a factor predisposing women to recurrent urinary tract infections. Our phase I study demonstrated the safety of a multi-strain vaccine administered as a vaginal suppository. A phase II study was conducted to determine vaccine efficacy.


METHODS
A total of 91 women susceptible to recurrent urinary tract infections was entered into the study and the courses were analyzed in a randomized, double-blind, placebo controlled trial of vaginal mucosal immunization. Subjects received 3 vaginal suppositories at weekly intervals. Depending on the treatment group each suppository contained 1 of 2 vaccine doses or suppository material only. Each patient was followed for 5 months to record infection episodes, and obtain urine, vaginal irrigates and serum to measure immunological responses.


RESULTS
Immunogen treated women who were off antibiotic prophylaxis throughout the study had a significant delay in interval to reinfection during the first 8 weeks compared to women receiving placebo. Mean interval until reinfection was delayed from 8.7 weeks for placebo treated to 13 weeks for vaccine treated women. Immunological responses in serum, urine and vaginal fluid were variable. No serious adverse effects were observed.


CONCLUSIONS
These data demonstrate that vaginal mucosal immunization can enhance resistance to urinary tract infections in susceptible patients.
Uehling
D T
DT
Department of Surgery, University of Wisconsin, Madison, USA.
Hopkins
W J
WJ
Balish
E
E
Xing
Y
Y
Heisey
D M
DM
D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000282:Administration, Intravaginal; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001428:Bacterial Vaccines / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D014552:Urinary Tract Infections / Q000628:therapy*
D000276:Adjuvants, Immunologic; D001428:Bacterial Vaccines; C055507:SolcoUrovac