Hibiscus extract, vegetable proteases and Commiphora myrrha are useful to prevent symptomatic UTI episode in patients affected by recurrent uncomplicated urinary tract infections

Abstract

Objective: To evaluate the efficacy of a combination of Hibiscus extract, vegetable proteases and Commiphora myrrha extract in the prophylaxis of symptomatic episode in women affected by recurrent urinary tract infections (rUTIs). Materials and methods: In this phase II clinical trial, all patients with history and diagnosis of rUTI were enrolled. All patients underwent the following treatment schedule: 1 tablet in the morning and 1 tablet in the evening for 7 days and, then, 1 tablet in the evening for 10 days (1 cycle every each month, for 6 months) of a combination of Hibiscus extract, vegetable proteases and Commiphora myrrha extract. At the baseline, all patients underwent urologic visit with quality of life (QoL) questionnaires and mid-stream urine culture. After 3 and 6 months, all patients underwent urologic visit, urine culture and QoL questionnaires evaluation. Results: Fifty-five women were enrolled (mean age 49.3; range: 28-61). At the enrollment time, the most common pathogen was Escherichia coli (63.7%). The median number of UTI per 6 months was 5 (IQR: 4-9). At the end of the second follow-up evaluation, 25 women did not reported any symptomatic episode of UTI (49%), 18 reported less than 2 episodes (35.3%), while 8 reported more than 2 episodes (15.7%). However, at the first and second follow-up evaluation the clinical statistically significant improvement (QoL) was reported by 38/51 (74.5%) (p < 0.001 from baseline) and 43/51 (84.3%) (p < 0.001 from baseline) women, respectively. The median number of UTI decreased to 2 (IQR: 0-3). At the end of the follow-up period, 30/51 had sterile urine (58.8%), while 21/51 (41.2%) reported a transition from symptomatic UTI to asymptomatic bacteriuria. Conclusions: In conclusion, this treatment, in motivated patients, is able to prevent symptomatic UTI symptomatic episode and improve patient’s QoL.

Xyloglucan, Hibiscus and Propolis to Reduce Symptoms and Antibiotics Use in Recurrent UTIs: A Prospective Study

“…In particular, the use of phytotherapy and nutraceuticals might represent a feasible and effective, alternative approach to curtail the use of antibiotics and the rate of symptomatic recurrences [3,13,19,20]. Recently, Cai et al published a paper about the efficacy of a combination of Hibiscus extract, vegetable proteases and Commiphora myrrha extract, for preventing symptomatic UTI episodes and improving patients' QoL [12].…”

“…Moreover, we excluded all patients with active infection by sexually transmitted pathogens. Immediately before enrolment a clinical and microbiological evaluation was performed by administering QoL questionnaires and performing a preliminary midstream urine culture, in line with Cai et al [3,12]. All screened women were informed about the nature of the study and about the fact that the suggested product is already present in Italy.…”

“…All urine samples were analyzed for common bacteria and yeasts, aliquoted for DNA extraction and PCR testing for Chlamydia trachomatis, Neisseria gonorrhoeae and urogenital Mycoplasma. Microbiological culture was performed according to the procedure described by Hooton et al [14], and all other microbiological procedures and DNA extraction were performed in line with Mazzoli et al [12,15]. For microbiological diagnosis, ≥10 5 CFU/ml was considered the cut-off for significant pathogenic growth [16]; the plate count method was performed in line with Mazzoli et al [12].…”

“…Microbiological culture was performed according to the procedure described by Hooton et al [14], and all other microbiological procedures and DNA extraction were performed in line with Mazzoli et al [12,15]. For microbiological diagnosis, ≥10 5 CFU/ml was considered the cut-off for significant pathogenic growth [16]; the plate count method was performed in line with Mazzoli et al [12]. At the enrolment phase, all women were asked to report the number of symptomatic recurrences had in the year before and the antibiotics taken (name, dosage and course).…”

Innovative medical technologies for the treatment of urinary tract infections in peri- and postmenopausal women

“…З огляду на низький рівень використання менопаузальної гормональної терапії в Україні (1-2%), зростання резистентності до антибіотиків, підвищення обізнаності про шкідливу дію антибактеріальних засобів на мікробіом піхви та кишечника, збільшення частоти рецидивів ІСШ, перед науковцями постає проблема пошуку альтернативних методів лікування ІСШ у жінок у клімактеричному періоді [9,15,21,26].…”