Nonpharmacologic Therapy

Although there is limited data in the literature and sometimes conflicting results, several nonpharmacologic therapies have been proposed for prevention of UTIs. The intake of large volumes of cranberry juice can decrease the number of UTIs over a year period in patients with recurrent UTIs but uncertain efficacy in the general popula-

tion.29 Probiotics such as Lactobacillus spp. have been used to decrease vaginal pH in

21-22

women which may decrease the growth of certain pathogenic bacteria. Topical estrogen replacement therapy significantly decreases the incidence of UTIs in post-

menopausal women compared to placebo. Methenamine hippurate and methenam-ine mandalate have no antimicrobial properties but decrease the incidence of UTIs when used for prophylaxis. Patient education of common risk factors is important.

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