The effectiveness of the combined dietary supplement Uronext in women with recurrent cystitis: a clinical and microbiological study.
Authors:   Research Center of Urology, Research Institute for Surgery and Emergency Medicine, I.P. Pavlov First Saint Petersburg State Medical University, Slesarevskaya M.N. ,   St. Petersburg, Russia, Kuzmin I.V. ,   Department of Urology, I.P. Pavlov First St. Petersburg State Medical University; St. Petersburg, Russia, Kraeva L.A. ,   Laboratory of Medical Bacteriology, St. Petersburg Pasteur Institute of Epidemiology and Microbiology; St. Petersburg, Russia, Smirnova E.V. ,   bacteriological laboratory of the Eastern branch of the Center for Hygiene and Epidemiology in the City of St. Petersburg; St. Petersburg, Russia
Published: January 2023

Introduction. Introduction Antibacterial therapy is the main line of treatment for lower urinary tract infections (LUTIs). At the same time, not always satisfactory efficacy and the growing problem of antibiotic resistance of the main uropathogens determine the importance of finding alternative approaches. Many studies have confirmed the clinical efficacy of non-antibacterial therapy for LUTIs, however, a number of aspects of its pharmacological action remain unclear. Aim. Assessment of the clinical and microbiological effects of the dietary supplement «Uronext», containing D-mannose, vitamin D and cranberry extract, in women with recurrent LUTIs. Materials and methods. Under supervision were 67 women aged 18 to 65 years (mean 42.8±12.9 years) with recurrent LUTIs. By the time the study began, all patients were diagnosed with an exacerbation of cystitis. The study consisted of two parts: clinical and laboratory. During the first of these, patients were prescribed Uronext 1 sachet (2000 mg of D-mannose, Cran-Max (highly purified 100% natural cranberry extract with standardized activity (36 mg of proanthocyanidins) and 1 μg of vitamin D3) daily for 7 days and studied the dynamics of the symptoms of cystitis. The laboratory part included an assessment of the minimum inhibitory concentration (MIC), adhesion index, degree and time characteristics of the antimicrobial activity of Uronext against the main uropathogens. Results. Reception Uronekst was accompanied by a positive dynamic of the severity of symptoms of cystitis. The average total score of the «typical» section of the ACSS questionnaire decreased from the initial 8.27±2.05 on the 1st day of the study to 4.73±1.98 by the 3rd day and to 4.16±2.03 by the 7th day of the study. mu day of admission. By this time, 37 (55.2%) women indicated a significant improvement in their condition, and 7 (10.4%) women indicated the complete disappearance of symptoms. Initially, bacteriuria in a titer of ≥1000 CFU/ml was detected in 50 (74.6%) patients, while the antimicrobial activity of Uronext against isolated uropathogens was 48%. In vitro, the product had an antibacterial effect on both Gram-negative and Gram-positive uropathogens. At the same time, for gram-negative microorganisms, the MIC was 10 times lower than for gram-positive ones. In vitro antibacterial activity against uropathogens peaked 2 hours after the addition of Uronext to cell culture and persisted for at least 8 hours. A pronounced anti-adhesive effect of Uronext was revealed, leading to a decrease in the adhesion index to epithelial cells by 3.1–4.8 times, depending on the type of microorganisms. Conclusion. The appointment of a combined dietary supplement "Uronext" for patients with LUTI with exacerbation of cystitis seems to be a pathogenetically justified alternative to the use of antibiotics in this category of patients. The substances included in Uronext have a synergistic effect and contribute to its high microbiological efficiency