Pd63-12 a Multimodal Approach to Preventing Recurrent Utis: Alternatives to Antibiotics Work!

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder II (PD63)1 May 2024PD63-12 A MULTIMODAL APPROACH TO PREVENTING RECURRENT UTIS: ALTERNATIVES TO ANTIBIOTICS WORK! Emeka Udedibia, Grace Jun, Alexandra Tabakin, Karen Huang, Iyla Bagheri, Mazen Mansour, and Wai Lee Emeka UdedibiaEmeka Udedibia , Grace JunGrace Jun , Alexandra TabakinAlexandra Tabakin , Karen HuangKaren Huang , Iyla BagheriIyla Bagheri , Mazen MansourMazen Mansour , and Wai LeeWai Lee View All Author Informationhttps://doi.org/10.1097/01.JU.0001009384.23104.ca.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Recurrent urinary tract infections (rUTIs) are common in women, incurring high costs. Current interventions, like prophylactic antibiotics and methenamine, have limitations. Our study explores a novel approach—combining low-risk, non-antibiotic strategies for prevention. METHODS: We retrospectively analyzed patients seen by one provider at an academic center from 2020-2023. Inclusion criteria: females >18 years with ≥2 UTIs in 6 months or ≥3 in 12 months, follow-up ≥6 months. Exclusion criteria: urinary tract anomalies, catheter dependency, post-void residual ≥250 mL. Patients received counseling on up to five interventions: increased water intake (≥2.5L/day), vaginal estrogen, cranberry supplementation (≥36 mg proanthocyanidins), a 30-day course of vaginal probiotic suppositories (multi-strain Lactobacilli), and increased fiber for constipation. We assessed satisfaction with a 5-point Likert scale. We used Wilcoxon signed-rank test for analysis. RESULTS: Initially, 93 women met inclusion criteria, 7 were lost to follow-up, leaving a cohort of 86 women. Of these, 56.9% completed ≥3 interventions. Median follow-up interval was 7 months (IQR 5, 9.75). Following protocol initiation, median UTI occurrences decreased significantly from 3 (IQR 2, 4) to 0 (IQ 0, 1) (p<0.01). The majority experienced no UTIs (58.1%), while 22% had only 1 UTI. Stratification by pre- (n=35) and post-menopausal (n=51) status revealed significant UTI reductions post-intervention (p<0.01 for both) (Figure 1). Fully adherent patients (13.9%) showed the greatest improvement, with a significant reduction in median UTIs from 4 (IQR 3.25, 5) to 0 (IQR 0,0) (p=0.02). 16.2% of patients had instrumentation of the urinary tract during the study period without significant difference in UTI rate (p=.073). Average satisfaction with the protocol was high (4.62 out of 5, STD=0.85). CONCLUSIONS: Given rising antibiotic resistance and the need to preserve the vaginal and bladder microbiome, our study underscores the effectiveness of non-antibiotic interventions for rUTIs. The multimodal approach showed substantial UTI reductions, especially for adherent patients, as well as benefits for women across menstrual stages, offering a promising prevention strategy. Further, larger-scale analyses will elucidate its full benefits. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1296-e1297 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Emeka Udedibia More articles by this author Grace Jun More articles by this author Alexandra Tabakin More articles by this author Karen Huang More articles by this author Iyla Bagheri More articles by this author Mazen Mansour More articles by this author Wai Lee More articles by this author Expand All Advertisement PDF downloadLoading ...