Department of Infectious Diseases, ASFO Santa Maria degli Angeli Hospital of Pordenone, Pordenone, Italy.
Department of Anaesthesia and Intensive Care, ASFO Santa Maria dei Battuti Hospital of San Vito al Tagliamento (Pordenone), Pordenone, Italy.
Probiotics Antimicrob Proteins. 2024 Oct;16(5):1857-1865. doi: 10.1007/s12602-023-10141-y. Epub 2023 Aug 16.
Recurrent urinary tract infections (rUTIs) are a common condition with high morbidity and negatively impact the quality of life. They account for approximately 25% of all antibiotic prescriptions and are a public health concern in an era of increasing multidrug-resistant organisms (MDROs). Several non-antibiotic treatment strategies have been tried to curb antimicrobial use, and many are effective to some degree, but no experience testing multimodal interventions. We created a "care bundle" consisting of behavioral interventions, vaginal and oral probiotics, D-mannose, and cranberry to be followed for six months. We enrolled women with rUTIs over three years. Changes in urinary tract infections, antibiotic use, chronic symptoms, and quality of life were compared in the six months before and after participation in the study. Forty-seven women were enrolled in the study, six of whom were excluded from the final analysis. We observed a 76% reduction in urinary tract infections (p < 0.001) and a reduction in total antibiotic exposure of more than 90% (p < 0.001); all chronic symptoms showed a trend toward reduction. Adherence to the bundle was high (87.2%). Overall, 80.5% of women experienced an improvement in their quality of life. In our experience, a bundle protocol is effective in reducing recurrences and antimicrobial use in a cohort of women with rUTIs and results in a subjective improvement in chronic symptoms and quality of life. Further research with larger sample size is needed to confirm these findings.
复发性尿路感染（rUTI）是一种常见的疾病，发病率高，严重影响生活质量。rUTI 约占所有抗生素处方的 25%，在多药耐药菌（MDROs）日益增多的时代，成为公共卫生关注的问题。为了减少抗生素的使用，已经尝试了几种非抗生素治疗策略，其中许多在某种程度上是有效的，但没有经验测试多模式干预措施。我们创建了一个“护理包”，其中包括行为干预、阴道和口服益生菌、D-甘露糖和蔓越莓，需要持续使用六个月。我们在三年内招募了 rUTI 女性患者。在参与研究之前和之后的六个月内，比较了尿路感染、抗生素使用、慢性症状和生活质量的变化。共有 47 名女性参与了这项研究，其中 6 名被排除在最终分析之外。我们观察到尿路感染减少了 76%（p<0.001），抗生素总暴露量减少了 90%以上（p<0.001）；所有慢性症状都显示出减少的趋势。对护理包的依从性很高（87.2%）。总的来说，80.5%的女性生活质量得到了改善。根据我们的经验，在一组 rUTI 女性患者中，护理包方案可有效减少复发和抗生素使用，并导致慢性症状和生活质量的主观改善。需要进一步的研究，以确认这些发现。
