Intravesical hyaluronic acid and chondroitin sulfate for recurrent urinary tract infections: systematic review and meta-analysis

Goddard, Jonathan Charles; Janssen, Dick

doi:10.1007/s00192-017-3508-z

Cited by 41 publications

(22 citation statements)

References 33 publications

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“…• Conflicting results Hyaluronic acid (Constantinides et al, 2004;Birder and de Groat, 2007;Cicione et al, 2014;Ciani et al, 2016;Torella et al, 2016;Goddard and Janssen, 2018) • (Hills et al, 2001;Klein et al, 2010;Cusumano et al, 2011;Kranjčec et al, 2014;Domenici et al, 2016) • Reduction of adhesion • Fast effect after oral administration…”

Section: Nutraceuticalmentioning

confidence: 99%

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Alternative Therapeutic Options to Antibiotics for the Treatment of Urinary Tract Infections

et al. 2020

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Urinary tract infections (UTIs) mainly caused by Uropathogenic Escherichia coli (UPEC), are common bacterial infections. Many individuals suffer from chronically recurring UTIs, sometimes requiring long-term prophylactic antibiotic regimens. The global emergence of multi-drug resistant uropathogens in the last decade underlines the need for alternative non-antibiotic therapeutic and preventative strategies against UTIs. The research on non-antibiotic therapeutic options in UTIs has focused on the following phases of the pathogenesis: colonization, adherence of pathogens to uroepithelial cell receptors and invasion. In this review, we discuss vaccines, small compounds, nutraceuticals, immunomodulating agents, probiotics and bacteriophages, highlighting the challenges each of these approaches face. Most of these treatments show interesting but only preliminary results. Lactobacillus-containing products and cranberry products in conjunction with propolis have shown the most robust results to date and appear to be the most promising new alternative to currently used antibiotics. Larger efficacy clinical trials as well as studies on the interplay between non-antibiotic therapies, uropathogens and the host immune system are warranted.

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Section: Nutraceuticalmentioning

confidence: 99%

“…Recently a meta-analysis suggested that HA ± CS decreased the rate of UTI recurrence and increased the time to recurrence (Goddard and Janssen, 2018). Moreover the authors noted the safety of HA therapy even if the intravesical instillation is more invasive than other administrations (usually per os).…”

Section: Hyaluronic Acidmentioning

confidence: 99%

Alternative Therapeutic Options to Antibiotics for the Treatment of Urinary Tract Infections

et al. 2020

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“…SH instillations are costly and labour intensive [23,24]. However, these costs need to be weighed against the costs of antimicrobial resistance and the costs of treatment of adverse side effects of antimicrobials in patients.…”

Section: Discussionmentioning

confidence: 99%

Intravesical sodium hyaluronate reduces severity, frequency and improves quality of life in recurrent UTI

et al. 2019

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Purpose Urinary tract infections (UTI) occur in nearly half of all women at least once, with around 35% experiencing recurrences. Bladder mucosal glycosaminoglycan (GAG) layer damage is postulated to contribute. Sodium hyaluronate (SH) replenishes the GAG layer and is believed to be protective. However, there is limited literature on patient-reported outcomes and quality of life (QoL) after treatment. Our objective was to observe changes in UTI severity and QoL after treatment with intravesical SH. Methods In this retrospective, observational patient-reported outcome study, we examined outcomes in UTI patients treated with intravesical SH. SH was instilled weekly for 6 weeks. If symptoms persisted, patients received further instillations on demand. Patients were sent postal questionnaires to score symptoms before and after treatment. Patient-reported UTI occurrences before treatment were compared with recurrences after treatment collected from their primary care providers. Results There were 18 (58.1%) valid replies. The median age was 75. The median duration of illness before treatment was 4.5 (IQR 2.8-7) years. The median number of infections fell from ten per year (IQR 7-10) before treatment to two per year (IQR 0-5) after treatment. Pain improved by 34%, urgency 30%, nocturia 30%, frequency 32%, 'inability to carry out daily activities due to UTI related ill-health' 37% and 'loss of sleep' by 38%. Patients reported a 76% improvement in 'UTI-related QoL.' No adverse events were reported. Conclusion SH is safe and useful for managing patients with recurrent UTI, with improvements in symptoms, QoL, a decrease in the number of UTI episodes and in the best interests of antimicrobial stewardship.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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“…Alternative strategies to manage UTI s both in males and females. Data to reconstruct the figure were adopted and modified from different sources…”

Section: Management Of Utimentioning

confidence: 99%

Therapeutic potential of medicinal plants for the management of urinary tract infection: A systematic review

Shaheen

Akram

Jabeen

et al. 2019

Clin Exp Pharma Physio

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Urinary tract infection (UTI) is one of the most severe public health problem affecting both sexes but females are more susceptible due to the differences in urogenital and reproductive anatomy, physiology and lifestyle. As in UTI, different parts of the urinary tract are affected and morbidity due to UTI is more common in women of all ages and older men. Due to multi-drug resistant strains and high recurrence rate, UTI has become a major socioeconomic burden. The current review article was aimed to describe the natural therapeutic strategies to manage and cure the UTI. For this purpose, different databases including Google Scholar, Cochrane database, and PubMed etc. were explored. Inclusion criteria were any research article investigating the current therapy of UTI. It was found that microbial infections including Escherichia coli, Enterococcus faecalis and Klebsiella species are the major causes of UTI with different signs and symptoms including painful urination or dysuria, hematuria, urinary urgency, burning micturition, frequent urination, nausea, and vomiting. Antibiotics like trimethoprim, sulfamethoxazole, quinolone etc. as the first choice of the drug are used worldwide. However, due to microbial resistance, several life-threatening side effects, repeated high doses, high cost and low efficacy of these antibiotics motivated the researchers to explore natural remedies for the treatment of UTI. Herbal medicines are effective to combat bacterial resistance with high efficacy, and easy availability with minimal or no side effects. For these reasons it has attained the attention of researchers wanting to explore the herbal treatment of UTI. Vaccinium macrocarpon, Tribulus terrestris, Trachyspermum copticum, Cinnamomum verum and Hybanthusenn easpermus are some common medicinal plants reported to have therapeutic potential for the management and cure of the UTI. Although herbal medicines have more potential over conventional medicine but more discoveries are required to explore the phytoconstituents and their mechanism of action responsible for the management and cure of UTI.

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Intravesical hyaluronic acid and chondroitin sulfate for recurrent urinary tract infections: systematic review and meta-analysis

Cited by 41 publications

References 33 publications

Alternative Therapeutic Options to Antibiotics for the Treatment of Urinary Tract Infections

Alternative Therapeutic Options to Antibiotics for the Treatment of Urinary Tract Infections

Intravesical sodium hyaluronate reduces severity, frequency and improves quality of life in recurrent UTI

Therapeutic potential of medicinal plants for the management of urinary tract infection: A systematic review

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