Original Article Phytotherapy in Adults With Recurrent Uncomplicated Cystitis

• Published in: Deutsches Ärzteblatt international 2022-05, Vol.119 (20), p.353-360
• Main Authors: Kranz, Jennifer, Lackner, Julia, Künzel, Ulrike, Wagenlehner, Florian, Schmidt, Stefanie
• Format: Article
• Language: English
• ISSN: 1866-0452
• DOI: 10.3238/arztebl.m2022.0104

BACKGROUNDUncomplicated urinary tract infections are among the commonest bacterial infections. Because antibiotic resistance is on the rise, there is growing interest in alternative, non-antimicrobial treatment options. This systematic review presents the current evidence on phytotherapy for the treatment and prevention of recurrent uncomplicated cystitis. METHODSA systematic search of the relevant literature from January 2011 to August 2021 was carried out in the MEDLINE, Embase, and Cochrane Library databases and in two clinical trial registries. The trials included in the present review are ran - domized controlled trials (RCTs) of phytotherapeutic agents as monotherapy or combination therapy, in comparison to placebo, no treatment, non-pharmacological treatment, or drug treatment without any phytotherapeutic component. Two of the authors independently selected the publications, extracted the data, and estimated the risk of bias using the Cochrane Risk of Bias Tool. RESULTS12 RCTs with a total of 1797 female patients were included. A trial of acute therapy with Chinese plant-based medicine revealed non-inferiority to antibiotic treatment. Six trials of prophylaxis with cranberry products yielded mixed results with regard to efficacy against recurrent urinary tract infections. A trial of Seidlitzia rosmarinus for the prevention of cystitis showed that its use was associated with a lower cystitis rate than placebo (at 6 months: 33 vs. 73%, p