title: [Non-Antibiotic Strategies to Prevent the Recurrence of Uncomplicated Urinary Tract Infections in Women].
abstract: The aim of all medical treatment is "primum nihil nocere" ("First, do no harm").Restoring the integrity of intestinal microbiota and optimising the immune response in recurrent infections, especially in the urinary tract, are treatment alternatives which are closer to this target than the usual focus on antibiotic prevention of recurrence.In the future, antibiotics will continue to be recommended for the prevention of urinary tract infections on a case-by-case basis. However, the problems of an excessive use of antibiotics, e. g. resistance and long-term interference with intestinal microbiota, are forcing us to search for alternatives. The use of probiotics alone or in combination with immunotherapeutics, or the sole use of immunotherapeutics, are important treatment options, which are already routinely available in clinical practice. These therapies are focused on the pathomechanism of an infection and tackle the root cause of the problem. Phytotherapeutics or small molecules like mannose, which restricts the adherence of bacteria to the urothelium, are complementary approaches.The EAU guidelines recommend the following treatments for the long-term prevention of urinary tract infections:Oral and parenteral immunostimulants (StroVac(®)), local estrogen replacement and administration of Lactobacillus rhamnosus and Lactobacillus reuteri.
authors.affiliation: Urologische Praxis Maximilianstraße, Ludwig-Maximilians-Universität München.
authors.forename: H W
authors.initials: HW
authors.lastname: Bauer
authors.affiliation: Institut für Molekulare Medizin und Zellforschung der Universität Freiburg.
authors.forename: W G
authors.initials: WG
authors.lastname: Bessler
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy*; D004352:Drug Resistance, Microbial; D015914:Estrogen Replacement Therapy; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D008517:Phytotherapy / Q000379:methods; D010936:Plant Extracts / Q000627:therapeutic use; D019936:Probiotics / Q000627:therapeutic use; D012008:Recurrence; D014552:Urinary Tract Infections / Q000188:drug therapy*; D029799:Vaccinium macrocarpon
chemical_list: D000900:Anti-Bacterial Agents; D010936:Plant Extracts