Beyond Antibiotics: Introducing Vaccine-Based Approaches to Recurrent UTIs in Women

J. Curtis Nickel, MD, FRCSC, the Canada Research Chair in Urologic Pain and Inflammation and Professor of Urology at Queen’s University in Kingston, Ontario, gives an overview of current and prospective treatment for recurrent urinary tract infections (UTIs), focusing on alternatives to antibiotics. He summarizes the history of antibiotics and the growing problem of antimicrobial resistance. Dr. Klotz then considers alternatives to antibiotics for recurrent UTI prevention and symptomatic UTI, including increased water intake, cranberry extract, probiotics such as D-mannose, methenamine hippurate, herbal and dietary therapies, and vaginal estrogen therapy. Dr. Nickel gives particular attention to promising developments surrounding a vaccine for recurrent UTI prevention.