Synopsis

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

Lactobacillus species are used as probiotics to support urinary tract health, including prevention of bladder infections (urinary tract infections, or UTIs), particularly in women. The rationale is based on the ability of certain Lactobacillus strains to colonize the vaginal and periurethral area, outcompeting uropathogens (mostly Escherichia coli) and restoring the normal microbiota disrupted by antibiotics or other factors. Some in vitro and in vivo studies suggest that Lactobacillus can inhibit pathogen adherence and produce substances (such as lactic acid and bacteriocins) that suppress uropathogen growth.

Clinical evidence remains limited and mixed. A few small randomized controlled trials (RCTs) have explored oral or intravaginal administration of Lactobacillus for UTI prevention. For example, a 2008 RCT (Beerepoot et al., Clinical Infectious Diseases) found that intravaginal Lactobacillus was somewhat effective in preventing recurrent UTIs, but less so than antibiotics. A 2012 Cochrane review concluded that while there is a theoretical basis and some promising results, overall evidence is insufficient to recommend probiotics as a standard UTI preventive strategy. The effect size appears modest, and benefits are mainly seen in women with recurrent infections.

In summary, use of Lactobacillus for bladder infection prevention is grounded in scientific rationale and some clinical research, but the supporting evidence is not robust or universally accepted. More large, well-designed trials are needed to clarify its effectiveness.

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