Probiotics as a Prophylactic Aid in Women With Recurrent Urinary Tract Infections (UTI's)

NCT ID: NCT00781625

Last Updated: 2008-10-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-10-31

Study Completion Date

2010-12-31

Brief Summary

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To investigate if administration of probiotics, either orally or vaginally,

* Can reduce the number of episodes of acute bacterial cystitis and/or
* Has tolerable adverse effect profile
* Improves general QoL in these women
* Improves the immune function and other physiological stress markers
* Reduces inflammation in urinary bladder epithelium

Detailed Description

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Chronic recurrent bacterial cystitis is a condition that is disabling to a great extent and which influences quality of life and freedom of movement. The episodes can be painful, and lead to extensive use of antibiotics, which in itself promotes development of bacterial strains increasingly resistant to antibiotics, but do not prevent relapses. Almost all cystitis' in women are ascending infections from bacteria in the vagina, following colonization from the rectum. There have, however, been reported indications that there may be bacteria colonies within the urothelium that might give rise to relapses of the infections, rather than pure reinfection from ascending pathogens.

Probiotics are cultures of viable microorganisms, which show a positive effect on the general condition of the host when administered. Among the lactic acid bacteria (LAB), lactobacilli are the most commonly used for probiotics, and they have an excellent safety record. In terms of UTI, weekly or twice weekly intravaginal instillation of Lactobacillus strains GR-1 and B-54 have led to reduced recurrences. This concept has been supported by a 2006 pilot study showing that intravaginal administration of Lactobacillus crispatus GAI 98322 every two days for one year, had the potential to reduce the UTI recurrences. Another approach has been taken whereby lactobacilli are administered orally with a view of simulating how the pathogens reach the vagina. The studies have shown that L. rhamnosus GR-1 and L. reuteri (formerly fermentum) RC-14 can reach the vagina after daily oral ingestion, and they can lower the bacterial and yeast pathogen numbers.

The aim of the study is to try to normalize the vaginal bacteriological milieu so that the more pathogenic subpopulation of bacteria strains are displaced and are less likely to cause UTI.

Conditions

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Urinary Tract Infections

Keywords

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probiotics QoL inflammation nutritional factors prophylactic aid Lactobacillus rhamnosus GR-1 Lactobacillus reuteri RC-14 Recurrent lower UTI in women

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Probiotic vaginal capsules

Probiotic vaginal capsule, placebo oral capsule

Group Type ACTIVE_COMPARATOR

UREX-cap-5

Intervention Type DIETARY_SUPPLEMENT

Size 3, white/white capsule, each containing 180 mg of a standardized, light beige fine powder consisting of freeze-dried cultures of: Lactobacillus rhamnosus, GR-1® (50%) Lactobacillus reuteri, RC-14® (50%) Ingredients Powder: Cultures, glucose anhydrate, potato starch, microcrystalline cellulose and magnesium stearate. Capsule: Gelatine, titanium dioxide Concentration Minimum of 5.4 billion (5.4 x 109) Colony Forming Units per capsule by end of bulk shelf life. Application For use as a dietary supplement. Packaging 20,000 capsules packaged in heat-sealed foil pouch.

placebo

placebo oral capsule, placebo vaginal capsule

Group Type PLACEBO_COMPARATOR

Placebo Y cap G-3

Intervention Type DIETARY_SUPPLEMENT

Size 3, white/white capsule, each contaiing180 mg placebo blended powder. Daily oral and vaginal intake for a total duration of 6 months

Probiotic oral capsules

Probiotic oral capsules, placebo vaginal capsules

Group Type ACTIVE_COMPARATOR

UREX-cap-5

Intervention Type DIETARY_SUPPLEMENT

Size 3, white/white capsule, each containing 180 mg of a standardized, light beige fine powder consisting of freeze-dried cultures of: Lactobacillus rhamnosus, GR-1® (50%) Lactobacillus reuteri, RC-14® (50%) Ingredients Powder: Cultures, glucose anhydrate, potato starch, microcrystalline cellulose and magnesium stearate. Capsule: Gelatine, titanium dioxide Concentration Minimum of 5.4 billion (5.4 x 109) Colony Forming Units per capsule by end of bulk shelf life. Application For use as a dietary supplement. Packaging 20,000 capsules packaged in heat-sealed foil pouch.

Interventions

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UREX-cap-5

Size 3, white/white capsule, each containing 180 mg of a standardized, light beige fine powder consisting of freeze-dried cultures of: Lactobacillus rhamnosus, GR-1® (50%) Lactobacillus reuteri, RC-14® (50%) Ingredients Powder: Cultures, glucose anhydrate, potato starch, microcrystalline cellulose and magnesium stearate. Capsule: Gelatine, titanium dioxide Concentration Minimum of 5.4 billion (5.4 x 109) Colony Forming Units per capsule by end of bulk shelf life. Application For use as a dietary supplement. Packaging 20,000 capsules packaged in heat-sealed foil pouch.

Intervention Type DIETARY_SUPPLEMENT

UREX-cap-5

Size 3, white/white capsule, each containing 180 mg of a standardized, light beige fine powder consisting of freeze-dried cultures of: Lactobacillus rhamnosus, GR-1® (50%) Lactobacillus reuteri, RC-14® (50%) Ingredients Powder: Cultures, glucose anhydrate, potato starch, microcrystalline cellulose and magnesium stearate. Capsule: Gelatine, titanium dioxide Concentration Minimum of 5.4 billion (5.4 x 109) Colony Forming Units per capsule by end of bulk shelf life. Application For use as a dietary supplement. Packaging 20,000 capsules packaged in heat-sealed foil pouch.

Intervention Type DIETARY_SUPPLEMENT

Placebo Y cap G-3

Size 3, white/white capsule, each contaiing180 mg placebo blended powder. Daily oral and vaginal intake for a total duration of 6 months

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* women 18-70 years old
* spontaneous urination
* \> 3 UTI's previous year
* no ongoing prophylactic antibiotic treatment

Exclusion Criteria

* \> 50 ml residual urine
* neurological bladder disease
* known neoplasia, kidney stone or urinary tract abnormalities
* use og indwelling catheter
* pregnancy
* diabetes
* infrequent voiding pattern
* symptoms that indicate interstitial cystitis
* creatinin \> 250 micmol/L
* participating in other clinical trial
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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St. Olavs Hospital

OTHER

Sponsor Role collaborator

Karolinska Institutet

OTHER

Sponsor Role collaborator

University of Oslo

OTHER

Sponsor Role collaborator

Folkehelsa

UNKNOWN

Sponsor Role collaborator

University Hospital, Akershus

OTHER

Sponsor Role lead

Responsible Party

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Urologisk avdeling, Akershus Universitetssykehus HF

Principal Investigators

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Caroline U Skagemo, MD

Role: PRINCIPAL_INVESTIGATOR

Akershus Universitetssykehus HF

Gunn Iren Meling, PhD. MD

Role: STUDY_DIRECTOR

Akershus Universitetssykehus HF

Locations

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Akershus Universitetssykehus HF

Lørenskog, Akershus, Norway

Site Status RECRUITING

St.Olavs Hospital

Trondheim, , Norway

Site Status ACTIVE_NOT_RECRUITING

Countries

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Norway

Central Contacts

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Caroline Ursin Skagemo, MD

Role: CONTACT

Phone: +47 02900111

Email: [email protected]

Gunn Iren Meling, PhD, MD

Role: CONTACT

Phone: +47 02900111

Email: [email protected]

Facility Contacts

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Caroline U Skagemo, MD

Role: primary

Gunn Iren Meling, PhD, MD

Role: backup

Other Identifiers

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08/7922(Shdir)

Identifier Type: -

Identifier Source: secondary_id

S-08458d (REK)

Identifier Type: -

Identifier Source: org_study_id