{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T13:35:02Z","timestamp":1792503302794,"version":"4.5.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100013015","name":"Cedars-Sinai Medical Center","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100013015","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Urogynecol J"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction and hypothesis<\/jats:title>\n                <jats:p>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.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>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.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>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 <jats:italic>Lactobacillus crispatus<\/jats:italic> and were not randomized. Three studies demonstrated the efficacy and safety of Lactobacillus as a vaginal suppository.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Current data support the use of vaginal suppositories containing <jats:italic>Lactobacillus<\/jats:italic> 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.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00192-023-05568-4","type":"journal-article","created":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T13:01:31Z","timestamp":1688216491000},"page":"2713-2718","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Can vaginal lactobacillus suppositories help reduce urinary tract infections?"],"prefix":"10.1007","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0057-6977","authenticated-orcid":false,"given":"Poone S.","family":"Shoureshi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarissa","family":"Niino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karyn S.","family":"Eilber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,7,1]]},"reference":[{"key":"5568_CR1","doi-asserted-by":"publisher","unstructured":"Recurrent Uncomplicated Urinary Tract Infections in Women: AUA\/CUA\/SUFU Guideline. https:\/\/doi.org\/10.1097\/JU.0000000000000296.","DOI":"10.1097\/JU.0000000000000296"},{"issue":"2","key":"5568_CR2","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1067\/mda.2003.7","volume":"49","author":"B Foxman","year":"2003","unstructured":"Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Dis Mon. 2003;49(2):53\u201370. https:\/\/doi.org\/10.1067\/mda.2003.7.","journal-title":"Dis Mon"},{"issue":"1","key":"5568_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.idc.2013.09.003","volume":"28","author":"B Foxman","year":"2014","unstructured":"Foxman B. Urinary tract infection syndromes: occurrence, recurrence, bacteriology, risk factors, and disease burden. Infect Dis Clin North Am. 2014;28(1):1\u201313. https:\/\/doi.org\/10.1016\/j.idc.2013.09.003.","journal-title":"Infect Dis Clin North Am"},{"key":"5568_CR4","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.urology.2019.01.031","volume":"128","author":"S Gaitonde","year":"2019","unstructured":"Gaitonde S, Malik RD, Zimmern PE. Financial burden of recurrent urinary tract infections in women: a time-driven activity-based cost analysis. Urology. 2019;128:47\u201354. https:\/\/doi.org\/10.1016\/j.urology.2019.01.031.","journal-title":"Urology"},{"issue":"6","key":"5568_CR5","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1016\/j.anaerobe.2011.04.014","volume":"17","author":"SD Forssten","year":"2011","unstructured":"Forssten SD, Sindelar CW, Ouwehand AC. Probiotics from an industrial perspective. Anaerobe. 2011;17(6):410\u2013413. https:\/\/doi.org\/10.1016\/j.anaerobe.2011.04.014.","journal-title":"Anaerobe"},{"issue":"3","key":"5568_CR6","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1007\/s00404-013-3064-9","volume":"289","author":"S Borges","year":"2014","unstructured":"Borges S, Silva J, Teixeira P. The role of lactobacilli and probiotics in maintaining vaginal health. Arch Gynecol Obstet. 2014;289(3):479\u201389. https:\/\/doi.org\/10.1007\/s00404-013-3064-9.","journal-title":"Arch Gynecol Obstet"},{"issue":"9","key":"5568_CR7","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1016\/j.resmic.2017.04.001","volume":"168","author":"G Tachedjian","year":"2017","unstructured":"Tachedjian G, Aldunate M, Bradshaw CS, Cone RA. The role of lactic acid production by probiotic Lactobacillus species in vaginal health. Res Microbiol. 2017;168(9):782\u2013792. https:\/\/doi.org\/10.1016\/j.resmic.2017.04.001.","journal-title":"Res Microbiol"},{"issue":"2","key":"5568_CR8","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1111\/1471-0528.15870","volume":"127","author":"J Van de Wijgert","year":"2020","unstructured":"Van de Wijgert J, Verwijs M. Lactobacilli-containing vaginal probiotics to cure or prevent bacterial or fungal vaginal dysbiosis: a systematic review and recommendations for future trial designs. BJOG. 2020;127(2):287\u2013299. https:\/\/doi.org\/10.1111\/1471-0528.15870.","journal-title":"BJOG"},{"key":"5568_CR9","doi-asserted-by":"publisher","unstructured":"Nader-Mac\u00edas MEF, De Gregorio PR, Silva JA. Probiotic lactobacilli in formulas and hygiene products for the health of the urogenital tract.\u00a0Pharmacol Res Perspect. 2021;9(5):e00787. https:\/\/doi.org\/10.1002\/prp2.787.","DOI":"10.1002\/prp2.787"},{"key":"5568_CR10","doi-asserted-by":"publisher","unstructured":"Baerheim A, Larsen E, Digranes A. Vaginal application of lactobacilli in the prophylaxis of recurrent lower urinary tract infection in women. Scand J Prim Health Care. 1994;12(4):239\u201343. https:\/\/doi.org\/10.3109\/02813439409029247.","DOI":"10.3109\/02813439409029247"},{"issue":"3","key":"5568_CR11","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1139\/m88-062","volume":"34","author":"AW Bruce","year":"1988","unstructured":"Bruce AW, Reid G. Intravaginal instillation of lactobacilli for prevention of recurrent urinary tract infections. Can J Microbiol. 1988;34(3):339\u201343. https:\/\/doi.org\/10.1139\/m88-062.","journal-title":"Can J Microbiol"},{"issue":"5","key":"5568_CR12","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1080\/01443615.2017.1399992","volume":"38","author":"A Cianci","year":"2018","unstructured":"Cianci A, Cicinelli E, De Leo V, et al. Observational prospective study on Lactobacillus plantarum P 17630 in the prevention of vaginal infections, during and after systemic antibiotic therapy or in women with recurrent vaginal or genitourinary infections. J Obstet Gynaecol. 2018;38(5):693\u20136. https:\/\/doi.org\/10.1080\/01443615.2017.1399992.","journal-title":"J Obstet Gynaecol"},{"key":"5568_CR13","doi-asserted-by":"publisher","first-page":"35387","DOI":"10.1155\/2007\/35387","volume":"2007","author":"CA Czaja","year":"2007","unstructured":"Czaja CA, Stapleton AE, Yarova-Yarovaya Y, Stamm WE. Phase I trial of a Lactobacillus crispatus vaginal suppository for prevention of recurrent urinary tract infection in women. Infect Dis Obstet Gynecol. 2007;2007:35387. https:\/\/doi.org\/10.1155\/2007\/35387.","journal-title":"Infect Dis Obstet Gynecol"},{"issue":"1","key":"5568_CR14","first-page":"11","volume":"14","author":"G Reid","year":"1992","unstructured":"Reid G, Bruce AW, Taylor M. Influence of three-day antimicrobial therapy and lactobacillus vaginal suppositories on recurrence of urinary tract infections. Clin Ther. 1992;14(1):11\u20136.","journal-title":"Clin Ther"},{"issue":"10","key":"5568_CR15","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.1111\/iju.14636","volume":"28","author":"T Sadahira","year":"2021","unstructured":"Sadahira T, Wada K, Araki M, et al. Efficacy of Lactobacillus vaginal suppositories for the prevention of recurrent cystitis: a phase II clinical trial. Int J Urol. 2021;28(10):1026\u201331. https:\/\/doi.org\/10.1111\/iju.14636.","journal-title":"Int J Urol"},{"issue":"10","key":"5568_CR16","doi-asserted-by":"publisher","first-page":"1212","DOI":"10.1093\/cid\/cir183","volume":"52","author":"AE Stapleton","year":"2011","unstructured":"Stapleton AE, Au-Yeung M, Hooton TM, et al. Randomized, placebo-controlled phase 2 trial of a Lactobacillus crispatus probiotic given intravaginally for prevention of recurrent urinary tract infection. Clin Infect Dis. 2011;52(10):1212\u20137. https:\/\/doi.org\/10.1093\/cid\/cir183.","journal-title":"Clin Infect Dis"},{"issue":"Suppl 1","key":"5568_CR17","doi-asserted-by":"publisher","first-page":"S30","DOI":"10.1016\/j.ijantimicag.2006.05.008","volume":"28","author":"S Uehara","year":"2006","unstructured":"Uehara S, Monden K, Nomoto K, Seno Y, Kariyama R, Kumon H. A pilot study evaluating the safety and effectiveness of Lactobacillus vaginal suppositories in patients with recurrent urinary tract infection. Int J Antimicrob Agents. 2006;28(Suppl 1):S30\u20134. https:\/\/doi.org\/10.1016\/j.ijantimicag.2006.05.008.","journal-title":"Int J Antimicrob Agents"},{"issue":"3","key":"5568_CR18","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1097\/JU.0000000000001843","volume":"206","author":"VCS Scott","year":"2021","unstructured":"Scott VCS, Thum LW, Sadun T, et al. Fear and frustration among women with recurrent urinary tract infections: findings from patient focus groups. J Urol. 2021;206(3):688\u201395. https:\/\/doi.org\/10.1097\/JU.0000000000001843.","journal-title":"J Urol"},{"issue":"717","key":"5568_CR19","doi-asserted-by":"publisher","first-page":"e252","DOI":"10.3399\/BJGP.2021.0603","volume":"72","author":"OA Gbinigie","year":"2022","unstructured":"Gbinigie OA, Tonkin-Crine S, Butler CC, Heneghan CJ, Boylan AM. Non-antibiotic treatment of acute urinary tract infection in primary care: a qualitative study. Br J Gen Pract. 2022;72(717):e252\u201360. https:\/\/doi.org\/10.3399\/BJGP.2021.0603.","journal-title":"Br J Gen Pract"},{"issue":"4","key":"5568_CR20","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1111\/j.1574-695X.1993.tb00337.x","volume":"6","author":"JA McGroarty","year":"1993","unstructured":"McGroarty JA. Probiotic use of lactobacilli in the human female urogenital tract. FEMS Immunol Med Microbiol. 1993;6(4):251\u201364.","journal-title":"FEMS Immunol Med Microbiol"},{"issue":"8","key":"5568_CR21","doi-asserted-by":"publisher","first-page":"e105998","DOI":"10.1371\/journal.pone.0105998","volume":"9","author":"JHHM Van de Wijgert","year":"2014","unstructured":"Van de Wijgert JHHM, Borgdorff H, Verhelst R, et al. The vaginal microbiota: what have we learned after a decade of molecular characterization? PLoS One. 2014;9(8):e105998. https:\/\/doi.org\/10.1371\/journal.pone.0105998.","journal-title":"PLoS One"},{"key":"5568_CR22","doi-asserted-by":"publisher","first-page":"IDRT.S3903","DOI":"10.4137\/IDRT.S3903","volume":"3","author":"MA Farage","year":"2010","unstructured":"Farage MA, Miller KW, Sobel JD. Dynamics of the vaginal ecosystem\u2014hormonal influences. Infect Dis (Auckl). 2010;3:IDRT.S3903. https:\/\/doi.org\/10.4137\/IDRT.S3903.","journal-title":"Infect Dis (Auckl)"},{"issue":"1","key":"5568_CR23","doi-asserted-by":"publisher","first-page":"2698","DOI":"10.1038\/s41598-022-06646-1","volume":"12","author":"F Hugenholtz","year":"2022","unstructured":"Hugenholtz F, van der Veer C, Terpstra ML, et al. Urine and vaginal microbiota compositions of postmenopausal and premenopausal women differ regardless of recurrent urinary tract infection and renal transplant status. Sci Rep. 2022;12(1):2698. https:\/\/doi.org\/10.1038\/s41598-022-06646-1.","journal-title":"Sci Rep"}],"container-title":["International Urogynecology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-023-05568-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00192-023-05568-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-023-05568-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T09:03:55Z","timestamp":1701075835000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00192-023-05568-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,1]]},"references-count":23,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["5568"],"URL":"https:\/\/doi.org\/10.1007\/s00192-023-05568-4","relation":{},"ISSN":["0937-3462","1433-3023"],"issn-type":[{"value":"0937-3462","type":"print"},{"value":"1433-3023","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,1]]},"assertion":[{"value":"2 February 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 April 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}