Probiotics for Prophylaxis and Treatment of Urinary Tract Infections in Children

Context Urinary tract infection (UTI) is a common and important problem during childhood that may cause chronic morbidities. Live beneficial microorganisms called probiotics have been investigated for their use in the prophylaxis and treatment of UTIs in children. Evidence Acquisition We aimed to discuss data about use, mechanisms and effects of probiotics on pediatric UTIs. We searched the literature, including PubMed, Medline and Cochrane databases from January 2001 to May 2016, and limited the search to English language. We used the key words probiotics, urinary tract infection, treatment, prophylaxis and children. Results Probiotics inhibit uropathogens by competition for receptors and nutrients, direct killing, immune modulation and production of inhibitory metabolites. There are many organisms that have been used as probiotics. Lactobacillus sp., Bifidobacterium sp. and Saccharomyces boulardii are the most commonly used and investigated probiotics. Although there are various benefits of probiotics for the pediatric population, some reports indicate rare complications such as bacteremia, sepsis, endocarditis, meningitis, UTI, abscesses, fungemia, pneumonia and chorioamnionitis. However, these are much less than the benefits of probiotics yet should be kept in mind. Continuing laboratory and clinical studies are encouraging the use of this strategy for the prevention and treatment of UTI in children. Conclusions Probiotics can be used as a natural and efficient alternative to antibiotics in UTI prophylaxis and treatment in children.