How the microbiome is influenced by the therapy of urological diseases: standard versus alternative approaches (article summary)

Until recently it was considered that urine of healthy people is sterile. However, with the use of new diagnostic methods it was demonstrated that microbiome with many various bacteria species is present in urinary bladder. Potential damage from bacteria in urinary bladder depends not only on their virulence but also on inflammatory response of the body. A protective effect of asymptomatic bacteriuria on urinary tract infections relapses was demonstrated. It was also established that some bacteria in the gut microbiome such as Oxalobacter formigenes protect from calcium oxalate stone formation. A fast increase in uropathogens antibiotic resistance is observed all over the world. The main reason for this is improper and sometimes unreasonable antibiotic use. It appears that instead of combating the pathogens it would be more useful to target the inflammatory body reaction and to preserve the protective bacterial flora. Due to its antiadhesive, antiinflammatory, spasmolytic, and antinociceptive effects the use of three herbs combination - centaury, lovage, and rosmary leaves, CLR (Canephron® N, Bionorica SE, Neumarkt, Germany) in the pilot study demonstrated excellent results in acute uncomplicated cystitis treatment. Also a phase 3 clinical study of CLR and fosfomycin trometamol use comparison has started. Gut microbiome assay in mice showed that even a single dose of fosfomycin as well as nitrofurantoin course result in substantive microbiome changes, whereas phytotherapy with CLR did not show any negative influence

microbiome, cystitis, urinary tract infection, phytotherapy