The role of non-antibacterial agents in the prevention of recurrent urinary tract infections

Background. Urinary tract infections are a pressing problem of modern medicine due to their widespread prevalence and socio-economic significance. Every year, recurrent urinary tract infections occur in more than 150 million people worldwide, which is second only to acute respiratory infections in incidence. In addition, the problem is not only medical, but also socio-economic in nature, since in most cases recurrent urinary tract infections occur among the working population. This can lead to temporary disability and a large number of outpatient consultations. Recurrent urinary tract infections are one of the main causes of hospital-acquired infections, which leads to serious financial expenses. In addition, the quality of life of such patients is significantly impaired: frequent relapses lead to disruption of the psycho-emotional state, the development of neuroses and psychosomatic pathology.

Results. Currently, antibiotic therapy takes the leading position in the treatment of recurrent urinary tract infections, as clearly indicated by both national and European clinical guidelines. At the same time, it should be noted that the tactics of preventive measures remain not fully developed and require further study and the formation of an evidence base. Due to the development of antibiotic resistance, including due to the irrational use of antibacterial drugs, and frequent adverse reactions, the role of non-antibacterial drugs in maintaining the health of the urinary tract is increasingly discussed in the literature. According to clinical guidelines developed by the European Association of Urology, antimicrobial drugs for prevention of relapses is addressed only in cases where the use of non-antibacterial agents has proven ineffective. Currently, European recommendations for the prevention of recurrent urinary tract infections include non-antibacterial agents such as D-mannose; preparations containing cranberries and/or products of its processing. Russian recommendations indicate the significant role of herbal medicine in the prevention of relapses of cystitis in women. Despite the fact that many non-antibacterial agents are already included in recommendations for the prevention of recurrent urinary tract infections, both European and national, their mechanism of action, dosage regimen, and duration of administration continue to be actively studied.

Conclusion. The currently accumulated clinical experience and research data indicate the great potential of such non-antibacterial agents as D-mannose, cranberry, vitamin D, birch leaf extract, which are part of the dietary supplement and can be used to maintain the health of the urinary tract.

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