Synopsis

Source of validity: Traditional
Rating (out of 5): 2

Acetic acid has a traditional role in the management of bladder infections, particularly in the form of bladder irrigation solutions such as "acetic acid irrigation." The rationale stems from its acidic properties, which can help lower the pH of urine and the bladder environment. Historically, the use of weak acid solutions was thought to inhibit the growth of certain pathogenic bacteria, especially in cases of chronic or recurrent urinary tract infections (UTIs) or after urologic procedures. Acetic acid solutions (commonly 0.25% to 0.5%) have been used in clinical settings as bladder irrigants, especially in patients with indwelling catheters to reduce encrustations and decrease colonization by urease-producing organisms. However, while this practice is grounded in tradition and has some clinical rationale, robust scientific validation through randomized controlled trials is limited. Most evidence comes from case series, small studies, or expert opinion rather than high-quality clinical research. Major guidelines do not routinely recommend acetic acid for the treatment of acute bladder infections (cystitis) in the general population. Instead, antibiotics remain the standard of care. Acetic acid irrigation is mainly reserved for specific clinical scenarios, such as preventing catheter encrustation, rather than direct treatment of infection. Thus, the use is primarily traditional with modest supporting evidence.

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