Probiotic Therapy and Functional Foods for Prevention of Urinary Tract Infections: State of the Art and Science.

In the past year, interest has heightened in the potential for probiotics to prevent urinary tract infection (UTI). Mainly, this has been due to concerns about antibiotic resistance and recognition of the scientific efficacy of probiotics. The critical factors in any successful application of probiotics to patient care are the scientific basis for selecting probiotic strains and clinical verification that they are effective against the recurrence of UTI. Three strains--Lactobacillus rhamnosus GR-1 and Lactobacillus fermentum B-54 and RC-14--have been shown to colonize the vagina and act as a barrier to the ascension of uropathogens into the bladder. Their ability to produce growth and adhesion antagonists against urogenital pathogens is clinically important, because these appear to be important mechanisms of action. Probiotic therapy has been shown to be safe, but too few reliable products are on the market, and none are yet available for use against UTI. Given the right strains and delivery system, probiotic therapy could provide the first new UTI-prevention system in 40 years, and may help in the management of recurrent UTI.