The use of probiotics, especially lactobacilli might be a good candidate for preventive use of UTIs. Since lactobacilli dominate a healthy urogenital flora, restoration of the urogenital flora with lactobacilli, may protect against UTIs. Lactobacilli exert their health-promoting effects through several mechanisms:, they:
Produce lactic acid and bacteriocins that directly kill or inhibit bacterial and viral pathogens
Form micro-colonies that adhere to the epithelial cell receptors and form a physical barrier against pathogen adhesion
Stimulate the host immune system
Not all lactobacilli can exert the same health effects and therefore, the bacterial strains for probiotic formulation intended to prevent RUTIs have to be carefully selected based on the characteristics of the strain.
Several, in vitro and in vivo studies support the beneficial effect of some lactobacilli strains on the restoration of the vaginal flora and the prevention of RUTIs [5,6,7]. The evidence suggests that probiotics can be beneficial for preventing RUTIs in women. As probiotics are already in use in many fermented products, there are no major safety concerns. Especially, latcobacili have GRAS (generally regarded safe to use) status . Probiotics show a promising role in becoming an alternative or complementary treatment option for RUTIs and might in the future replace antibiotics as the standard treatment solution.