TY - CHAP T1 - Non-antimicrobial prophylactic measures in recurrent urinary tract infections T2 - Urogenital Infections and Inflammations AU - Vallée, Maxime AU - Bruyère, Franck ED - Naber, Kurt G. AD - Dr Maxime Vallée, Poitiers University Hospital, Urology, 2 rue de la Milétrie, 86021, Poitiers, France, Phone: +33516604222, E-mail: maxime.vallee@chu-poitiers.fr N2 - The epidemiology of rUTIs is, at present, uncertain. About 50% of women will have UTI in their lives at least once, and 20% to 30% of these women will suffer again at least once. However, the proportion of these women with real rUTIs, at least 3 to 4 episodes per year, is not clearly known. The importance of the impact on the quality of life of women with rUTIs, as well as the impact of an increase in antibiotic prescriptions and bacterial resistance, have made this pathology an important area of research for many years now. The effectiveness of long-term antibiotic prophylaxis is demonstrated, however, the need to find alternatives to antibiotic treatment is essential today. The aim of this study was to conduct a systematic review of the literature on non-antimicrobial prophylactic measures available to prevent recurrence in adult women with rUTIs. A systematic review of the literature was performed according to the criteria PRISMA. All national and international recommendations were reviewed. A systematic literature search was performed for the last 20 years in the Cochrane and Medline libraries on 2018-07-09. The criteria for the studies to be retained were: all studies concerning female patients over 18 years who present rUTIs and received a different treatment than antibiotibic. After exclusion of duplicates a total of 226 publications were identified. A total of 70 publications were assessed for eligibility. In total, 34 studies were included into the review analysis. Cranberry, immunoactive prophylaxis, and vaginal oestrogen replacement in postmenopausal women are measures that can be recommended for the prevention of rUTIs in women. On the other hand, other measures such as probiotics, bacterial interference, endovesical instillation, behavioural modifications, Chinese herbal medicine, acupuncture, or D-mannose are not measures that can be currently recommended for the prevention of rUTIs. The challenge is twofold: to improve the quality of life of these patients, while limiting the prescription of antibiotics in the long term. Unfortunately, many of these non-antibiotic measures turn out to be alternatives that are often less effective than antibiotics, which remains the reference. The paradox of this pathology is to propose as many therapeutic alternatives for a pathology without risk but source of many difficulties for the patients as well as the practitioners who take care of them. Finally, recent work on urinary microbiota appears to be an essential step in understanding this complex pathology whose physiopathology is still uncertain. PY - 2022 DA - 2022/02/03 DO - 10.5680/lhuii000063 LA - en L1 - https://books.publisso.de/en/system/getFile/812 UR - https://dx.doi.org/10.5680/lhuii000063 L2 - https://dx.doi.org/10.5680/lhuii000063 PB - German Medical Science GMS Publishing House CY - Berlin ER -