Cai Tommaso, Cocci Andrea, Tiscione Daniele, Puglisi Marco, Di Maida Fabrizio, Malossini Gianni, Verze Paolo, Palmieri Alessandro, Mirone Vincenzo, Bjerklund Johansen Truls E
Department of Urology, Santa Chiara Regional Hospital, Trento.
Arch Ital Urol Androl. 2018 Jun 30;90(2):97-100. doi: 10.4081/aiua.2018.2.97.
To evaluate the efficacy of a phytotherapic combination of L-Methionine associated with Hibiscus sabdariffa and Boswellia serrata for treatment of acute episodes of uncomplicated urinary tract infections (UTI) in women affected by recurrent UTIs.
In this randomized phase III clinical trial, adult females with uncomplicated UTI were enrolled into one of the following treatment groups: Group A: phytotherapic combination 1 tablet in the morning and 1 tablet in the evening for 7 days; Group B: Short term antibiotic treatment according to international guidelines recommendations. At baseline, all patients were evaluated by a urologist and quality of life (QoL) questionnaires and mid-stream urine culture. Same clinical and laboratory investigations were repeated at each follow-up visit.
Forty-six patients were enrolled in Group A and 47 in Group B. At the first follow-up (30 days), both groups showed a statistically significant improvement in quality of life scores as compared with baseline assessment [Group A: (QoL 94.3 VS 98.5 p < 0.001); Group B: (QoL 94.5 VS 98.7 p < 0.001)]. An improvement from baseline was also seen at the second followup evaluation after 3 months [Group A: (QoL 94.3 VS 99.1 p < 0.001); Group B: (QoL 94.5 VS 98.1 p < 0.001)]. At the second follow-up visit, a statistically significant difference in QoL was reported between the two groups (99.1 VS 98.1; p < 0.003) and a transition from UTI to asymptomatic bacteriuria (ABU) was observed 12 of 46 (26%) patients in Group A, while no patients in Group B demonstrated ABU (p = 0.007).
Here, we demonstrated that this phytotherapic combination is able, in comparison to antibiotic treatment, to improve patients quality of life, reducing symptoms in acute setting and preventing the recurrences. Interestingly, a significantly higher proportion of patients in the phytotherapy group had ABU after three months. Our findings are of great interest in an antibiotic stewardship perspective.
评估L-蛋氨酸与玫瑰茄和乳香的植物疗法组合对复发性尿路感染女性单纯性尿路感染（UTI）急性发作的治疗效果。
在这项随机III期临床试验中，患有单纯性UTI的成年女性被纳入以下治疗组之一：A组：植物疗法组合，早晚各1片，共7天；B组：根据国际指南建议进行短期抗生素治疗。基线时，所有患者均由泌尿科医生进行评估，并填写生活质量（QoL）问卷和进行中段尿培养。每次随访时重复相同的临床和实验室检查。
A组纳入46例患者，B组纳入47例患者。在首次随访（30天）时，与基线评估相比，两组的生活质量评分均有统计学意义的改善[A组：（QoL 94.3对98.5，p<0.001）；B组：（QoL 94.5对98.7，p<0.001）]。3个月后的第二次随访评估时，与基线相比也有改善[A组：（QoL 94.3对99.1，p<0.001）；B组：（QoL 94.5对98.1，p<0.001）]。在第二次随访时，两组之间的QoL有统计学意义的差异（99.1对98.1；p<0.003），并且在A组46例患者中有12例（26%）观察到从UTI转变为无症状菌尿（ABU），而B组没有患者出现ABU（p = 0.007）。
在此，我们证明与抗生素治疗相比，这种植物疗法组合能够改善患者的生活质量，减轻急性发作时的症状并预防复发情况。有趣的是，植物疗法组中三个月后出现ABU的患者比例明显更高。从抗生素管理的角度来看，我们的研究结果具有重要意义。
