Synopsis

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

Probiotics have been studied as a supportive therapy for bladder infections (urinary tract infections, UTIs), particularly in women. The rationale is based on the ability of certain probiotic strains, especially Lactobacillus species, to restore and maintain the normal vaginal and urinary microbiota, which can be disrupted by antibiotics or other factors, potentially leading to recurrent infections. Some clinical trials and meta-analyses suggest that probiotics may reduce the risk of recurrent UTIs by competing with uropathogens (such as E. coli) for adhesion sites and producing substances that inhibit pathogen growth. However, results are mixed: while some studies report a reduction in UTI recurrence with probiotic use, others find no significant benefit compared to placebo. The most promising evidence pertains to intravaginal administration of Lactobacillus, with oral supplements showing less consistent results. The 2017 Cochrane review concluded that, while probiotics may be promising, the quality of evidence is low, and more robust, large-scale studies are needed. Major guidelines do not currently recommend probiotics as a first-line or standalone therapy for bladder infections, but they may be considered as adjuncts in prevention, especially in women with frequent recurrences who wish to avoid antibiotics. In summary, there is some scientific basis for the use of probiotics in preventing recurrent bladder infections, but the evidence is limited and not definitive.

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