Synopsis

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

Lactobacillus acidophilus is a probiotic bacterium commonly used to support urinary tract health, particularly in women prone to recurrent urinary tract infections (UTIs). The scientific rationale is based on its ability to colonize the vaginal and periurethral mucosa, potentially outcompeting or inhibiting the growth of uropathogenic bacteria such as Escherichia coli. Several small-scale clinical trials and observational studies have investigated the use of L. acidophilus (often as part of a multi-strain probiotic) for UTI prevention. For example, some studies have shown that vaginal or oral administration of lactobacilli may reduce UTI recurrence rates, especially following antibiotic use, which can disrupt normal flora. Proposed mechanisms include lowering vaginal pH, production of antimicrobial substances (e.g., hydrogen peroxide), and competitive exclusion. However, the overall quality of evidence is moderate at best. Meta-analyses and systematic reviews conclude that there is some evidence of benefit, but results are inconsistent due to heterogeneity in probiotic strains, dosages, and study designs. Guidelines from major urological societies generally do not recommend L. acidophilus as a first-line or sole preventive agent for UTIs due to insufficient high-quality evidence. In summary, L. acidophilus is used for UTI support based on plausible mechanisms and some supportive studies, but strong, consistent scientific validation is lacking, warranting a moderate evidence rating.

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