Can vaginal lactobacillus suppositories help reduce urinary tract infections?

source extracted confidence: high 2026-04-09
#humans #female #suppositories #prospective-studies #lactobacillus

Can vaginal lactobacillus suppositories help reduce urinary tract infections?

Shoureshi et al., 2023 | Int Urogynecol J | Systematic Review

Citation

Shoureshi Poone S, Niino Clarissa, Eilber Karyn S. Can vaginal lactobacillus suppositories help reduce urinary tract infections?. Int Urogynecol J. 2023-Nov;34(11):2713-2718. doi:10.1007/s00192-023-05568-4

Abstract

INTRODUCTION AND HYPOTHESIS: Recurrent urinary tract infections (rUTIs) are a burden to patients and the health care economy. Vaginal probiotics and supplements have gained significant attention in mainstream media and lay press as a non-antibiotic alternative. We performed a systematic review to determine whether vaginal probiotics are an effective means of prophylaxis for rUTI. METHODS: A PubMed/MEDLINE article search was performed from inception to August 2022 for prospective, in vivo use of vaginal suppositories for the prevention of rUTIs. Search terms included: vaginal probiotic suppository (34 results), vaginal probiotic randomized (184 results), vaginal probiotic prevention (441 results), vaginal probiotic UTI (21 results), and vaginal probiotic urinary tract infection (91 results). A total of 771 article titles and abstracts were screened. RESULTS: A total of 8 articles fit the inclusion criteria and were reviewed and summarized. Four were randomized controlled trials, with 3 of the studies having a placebo arm. Three were prospective cohort studies, and 1 was a single arm, open label trial. Five of the 7 articles that specifically evaluated for rUTI reduction with vaginal suppositories did find a decreased incidence with probiotic use; however, only 2 had statistically significant results. Both of these were studies of Lactobacillus crispatus and were not randomized. Three studies demonstrated the efficacy and safety of Lactobacillus as a vaginal suppository. CONCLUSION: Current data support the use of vaginal suppositories containing Lactobacillus as a safe, non-antibiotic measure, but actual reduction of rUTI in susceptible women remains inconclusive. The appropriate dosing and duration of therapy remain unknown.

Key Findings

A total of 8 articles fit the inclusion criteria and were reviewed and summarized. Four were randomized controlled trials, with 3 of the studies having a placebo arm. Three were prospective cohort studies, and 1 was a single arm, open label trial. Five of the 7 articles that specifically evaluated for rUTI reduction with vaginal suppositories did find a decreased incidence with probiotic use; however, only 2 had statistically significant results. Both of these were studies of Lactobacillus crisp

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Female
  • Suppositories
  • Prospective Studies
  • Lactobacillus
  • Vagina
  • Urinary Tract Infections

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Systematic Review, Journal Article, Research Support, Non-U.S. Gov't
  • Vertical: probiotics

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09