From the Guidelines
Treating a urinary tract infection (UTI) caused by Lactobacillus species requires a combination of antibiotics and management of underlying complicating factors, as recommended by the European Association of Urology guidelines 1. When considering treatment options, it's essential to note that Lactobacillus species are not typically pathogenic and are often beneficial, but in certain cases, such as immunocompromised patients or those with underlying urinary tract abnormalities, they can cause UTIs. Some key points to consider when treating Lactobacillus UTIs include:
- Using a combination of antibiotics, such as amoxicillin plus an aminoglycoside or a second-generation cephalosporin plus an aminoglycoside, as recommended for complicated UTIs 1
- Managing any urological abnormality and/or underlying complicating factors, as emphasized in the European Association of Urology guidelines 1
- Considering the use of ciprofloxacin only if the local resistance rate is <10% and the patient does not require hospitalization, as recommended in the guidelines 1
- Drinking plenty of water, urinating frequently, and considering over-the-counter pain relievers like ibuprofen for discomfort, as these can help alleviate symptoms It's also important to note that the European Association of Urology guidelines panel emphasizes the importance of clinical expertise in tailoring treatment decisions for individual patients, taking into account their unique circumstances and values 1.
From the Research
Treatment of UTI caused by Lactobacillus species
- There is limited information available on the treatment of UTIs caused by Lactobacillus species, as they are not typically considered pathogenic organisms in the urinary tract 2, 3, 4, 5, 6.
- However, some studies suggest that Lactobacillus species may have antimicrobial properties that could be beneficial in preventing or treating UTIs 3, 5.
- In one study, Lactobacillus isolates were found to have inhibitory activity against multi-drug resistant uropathogens, including E. coli and Enterococcus faecalis 3.
- Another study discussed the potential of lactobacilli in preventing recurrent UTIs, suggesting that they may be a useful alternative to antibiotics 5.
- It is essential to note that the treatment of UTIs should be guided by the results of urine culture and susceptibility testing, and antibiotics should be used judiciously to minimize the development of antibiotic resistance 2, 4, 6.
- In general, the treatment of UTIs caused by antibiotic-resistant organisms may involve the use of alternative antibiotics, such as fosfomycin, nitrofurantoin, or carbapenems, depending on the specific organism and its susceptibility pattern 2, 6.