The role of nonantibiotic treatment of community-acquired urinary tract infections.

PURPOSE OF REVIEW: To summarize evidence on the efficacy of nonantibiotic treatments in the prevention of recurrent urinary tract infections (UTIs). The need for antibiotic-free regimens seems to be imperative given the worldwide rates of resistance of uropathogens to available antibiotics.

RECENT FINDINGS: In the recently published literature, cranberry products and probiotics are the focus of research. They both seem to be effective in preventing recurrent UTIs compared with placebo, but their benefit becomes less clear when they are compared with antibiotics.

SUMMARY: A number of nonantibiotic-containing alternatives are available for the prevention of recurrent UTIs. For the majority of these alternatives, contradictory results have been published. These can be, at least partially, explained by variation in doses administered and duration of treatment. Selection of patients more likely to benefit from these interventions seems to be a realistic approach from a clinical-practice perspective, as well a worthwhile focus for future research.