Bladder Microbiome and Recurrent UTIs: Preventing Those Nasty Buggers

Suzette E. Sutherland, MD, MS, URPS, addresses the role of the microbiome in recurrent urinary tract infections (UTIs). She begins this 26-minute presentation by reviewing the bladder microbiome, noting that microbes support immune function and maintain the integrity of the bladder lining. She then transitions to prevention and treatment of the condition.

Non-antibiotic prevention strategies are discussed, focusing on hydration, cranberry supplements, estrogen, and probiotics. Probiotics are emphasized for their role in reducing UTI recurrence, but Sutherland stresses the importance of proper diagnosis and judicious antibiotic use to avoid contributing to antibiotic resistance. Catheter-associated UTIs are also addressed, with a preference for clean intermittent catheterization and bladder irrigation with gentamicin in severe cases. Overall, Dr. Sutherland advocates for a conservative, evidence-based approach, using antibiotics only when necessary to preserve the efficacy of these crucial medications.

Read More