Escherichia coli Nissle 1917 for the prevention of recurrent uncomplicated urinary tract infections in women: a pilot randomized placebo-controlled trial.
Maria Angela Cerruto, Sonia Costantino, Alessandro Tafuri et al.
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In 30 seconds
This pilot multicenter randomized controlled trial evaluated the efficacy of Escherichia coli Nissle 1917 (EcN) in preventing recurrent uncomplicated urinary tract infections (rUTIs) in 50 women. The study found that 16.7% of women treated with EcN experienced at least one microbiological recurrence compared to 42.3% in the placebo group, indicating a relative risk of 0.39 (95% CI 0.14-1.14; p = 0.089).
Key findings
- 16.7% of patients treated with EcN had a microbiological recurrence compared to 42.3% in the placebo group.
- Positive urine cultures at 12 weeks were 8.3% in the EcN group versus 23.1% in the placebo group.
- EcN treatment resulted in a significant improvement in the Vitality domain of the SF-36 at 24 weeks (Δ + 0.165 vs + 0.021; p = 0.041).
- EcN was generally well tolerated, with mild gastrointestinal side effects reported.
Why it matters
Recurrent urinary tract infections are common in women and often lead to repeated antibiotic use. This study suggests that EcN may offer a non-antimicrobial preventive strategy, potentially reducing reliance on antibiotics and improving patient quality of life.
What to keep in mind
The study is limited by its pilot nature and small sample size due to recruitment challenges during the COVID-19 pandemic.