Homeopathy & recurrent urinary tract infections

antibiotic dispensing in New Zealand doubled in just six years

Half of all women experience at least one Urinary tract infection (UTI) before 32 years of age.¹

UTI effects the urinary system which consists of the kidneys, the ureters, the bladder and the urethra, and is called cystitis when located in the bladder. Uncomplicated UTI indicates no urinary tract abnormalities, no kidney involvement, and no promoting existing disease/s, and is classified as recurrent (R-UTI) if there are two or more UTI within six months, or more than three in one year.²

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UTI & Antimicrobial resistance

Antibiotic dispensing in New Zealand (for all conditions) increased by almost 50% from 2006-2014³ - UTI is one of the most common conditions for antibiotic prescription,⁴ and predictably, our historically low rates of antimicrobial resistance (AMR) are rising, particularly in Escherichia coli, Neisseria gonorrhoeae and Staphylococcus aureus.⁵

In Australia, where the (2020) annual direct cost of UTI was $909 million,⁶ Escherichia coli (E. coli) is identified as the cause in 70-95% of all uncomplicated UTI; and implicated in 50% of UTI. E. coli induced UTI hospital admission are estimated to cost AUD$ 2.3 million annually.⁷ AMR, especially in E. coli, rose steadily during 2013–2017⁸ and as of 2019 is a major worldwide barrier to effective UTI treatment.⁹

Trimethoprim, routinely prescribed in Australia for uncomplicated UTI¹⁰ was contributing to rising rates of AMR over a decade ago,¹¹ and a 34% AMR rate was detected in 2016 UK samples.¹²

Clearly there is a pressing need for novel antimicrobial treatments.

A change in the clinical use of antibiotics and recognition of the importance of the innate immune system should be important considerations in combating antimicrobial resistance.¹³

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UTI, AMR & homeopathy?

Bactericidal effects of homeopathic medicines against E. coli have been observed in vitro¹⁴¹⁵ however, this is not in accordance with the general hypothesis of homeopathy - that a homeopathic medicine effect activates the immune system to prevent adhesion of bacteria, rather than by direct bactericidal or bacteriostatic effects.¹⁶

Animal trials have found reduced diarrhea and intestinal burdens of E. coli via treatment with homeopathic medicine.¹⁷¹⁸¹⁹²⁰²¹²²

Homeopathy shows potential for significant reduction in the use of antibiotics and further methodologically high-quality human and veterinary homeopathy studies are urgently needed due to the global threat of antibiotic resistance. Effectiveness of homeopathy in general, in particular treatment of infections, is adequately proven for further research in this field.²³

For more on this crucial topic see an earlier article Homeopathy & Infections.²⁴

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Classical homeopathy offers highly individualized medicine based on the application of the therapeutic similitude principle - that disease may be addressed via use of the substance which produces similar symptoms.²⁵

Individualized homeopathy (I-Hom) aka classical homeopathy outlines the process whereby a single homeopathic medicine is chosen based on the totality of signs and symptoms of an individual,²⁶ that is, concomitant conditions and diseases, psychological features and feelings, all inform the homeopathic prescription²⁷ – no generalized homeopathic medicine by condition exists.²⁸

It is important to state here that I-Hom has an evidence base.²⁹

A homeopath must be able to apply coherence in their working knowledge of homeopathic principles in order to be able to assist people suffering chronic disease to improved health.³⁰ (HINT when trying to find a competent homeopath I advise you read their work in chronic disease ideally they will have published (peer reviewed) case studies.)

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Peer reviewed I-Hom case series report reduction in R-UTI, AMR induced R-UTI, and antibiotic use.

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Gaertner et al., (2020) Individualized Homeopathic Treatment in Women with Recurrent Cystitis: A Retrospective Case Series.³¹ Four Swiss outpatients experiencing R-UTI for more than 10 years, and had more than 10 courses antibiotic (AB) drugs dispensed during the preceding 12 months.

• Each presented with a history of R-UTI lasting an average of 13.5 years, with all reporting increased frequency of UTI episodes, occurring at least monthly over the preceding 10 months.

• All women had tried several other forms of therapies, including weekly intake of AB as prophylaxis.

• Each had been diagnosed with R-UTI via thorough case history, urine cultures, and abdominal and vaginal examinations. Urine cultures mostly showed growths of pan-sensitive Escherichia coli.

• All had been treated unsuccessfully with several conventional approaches and needed a course of AB at least every 2 months at the time of inclusion. R-UTI was treated with classical homeopathy after several conventional approaches revealed no improvement. The minimum follow-up period was 3 years.

‘The treatment resulted in a reduction of urinary tract infections and the need for antibiotics from monthly to less than 3 times a year. Three of the four women had no cystitis and related intake of antibiotics for more than 1.5 years. A relapse of symptoms could be treated efficiently with a repetition of the homeopathic remedy. All subjective outcome assessments resulted positive.’

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Chand and Kapoor (2020) Two Case Reports of Integrated Management of Antibiotic-Resistant Urinary Tract Infection.³²

• Case 1 presented with chronic multi-morbid conditions, including R-UTI which had become multi-drug resistant. With regular homeopathic treatment, her antibiotic use reduced, her diabetic profile improved, and she did not need prophylactic antibiotics.

• Case 2 suffered from R-UTI with post-coital cystitis and burning sensation, despite following all conventional advice for treatment and prophylaxis. Addition of homeopathy improved her quality of life and prevented relapses.

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Pannek et al., (2019) Usefulness of classical homeopathy for the prophylaxis of recurrent urinary tract infections in individuals with chronic neurogenic lower urinary tract dysfunction.³³

• Participants were treated either with a standardized prophylaxis alone or in combination with homeopathy. The number of UTI, general and specific quality of life (QoL), and satisfaction with homeopathic treatment were assessed prospectively for one year.

• Ten patients were in the control group; 25 patients received adjunctive homeopathic treatment. The median number of self-reported UTI in the homeopathy group decreased significantly, whereas it remained unchanged in the control group. The domain incontinence impact of the KHQ improved significantly (P = 0.035), whereas the general QoL did not change. The satisfaction with homeopathic care was high.

Whereas treatment and control group were not statistically different in the demographic parameters, there was a significance difference in the number of UTI/year at the beginning of the study. The number of UTI at the end of the study was not statistically different between the two groups, but it remained unchanged in the control group whereas it was significantly reduced in the treatment group.

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Nwabudike (2017) Classical homeopathy and bacterial urinary tract infections.³⁴

• Case 1 is that of a 1 year-old female with a 4-month history of R-UTI growing Escherichia Coli and fever. The patient responded to antibiotics, but relapsed repeatedly. Echography showed no abnormalities of the genitourinary tract. The patient was treated with homeopathic Phosphorus and improved, with clearing of the urinary tract infection.

• Case 2 is that of a 36-year old female presenting glossodynia and dysuria of 4 years duration. Cultures were positive for Candida Albicans on the tongue and for Escherichia Coli in the urine. She had failed to respond to treatment. Past history included a thyroid nodule, dyspareunia, erythematous rosacea and melasma. She received homeopathic Platinum metallicum as well as homeopathic candida albicans, and collibacillinum. She improved and developed negative tongue and urine cultures.

• Case 3 is that of a 54-year old female with a 3-year history of R-UTI due to Klebsiella spp, which failed to respond to repeated antibiotic therapy during this period. Past history included a cerebrovascular accident with complications treated also by this physician. She received the homeopathic medicines Causticum, as well as Cantharis and Eupatropium for her symptoms. She improved, with negative cultures.

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Pannek et al., (2014) Usefulness of classical homoeopathy for the prevention of urinary tract infections in patients with neurogenic bladder dysfunction: A case series.³⁵

Eight patients with spinal cord injury (SCI) and R-UTI were followed up for a median period of 15 months. Five patients remained free of UTI, whereas UTI frequency was reduced in three patients.

Our initial experience with homoeopathic prevention of UTI as add on to standard urologic prophylactic measures is encouraging. For an evidence‑based evaluation of this concept, prospective studies are required (Pannek et al., 2019). Keys for the positive outcome of this case series are co‑operation of well‑qualified partners, mutual respect and the motivation to co‑operate closely.

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Baruah and Dutta (2020) Homeopathy in the treatment of recurrent urinary tract infection a case report.³⁶

A 35-year-old female presented with the complaint of recurrent UTI for last 5 months along with some other complaints. After a thorough evaluation, we treated the case with homeopathic medicine, Lycopodium clavatum for a considerable period. After complete resolution of symptoms, no further recurrence was noted in the next 6 months of follow-up.

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Noninfectious cystitis can be due to a variety of causes and may even be idiopathic in nature such as interstitial cystitis.

The first case study I ever published was a (poorly presented) case of a 26 year old woman who had suffered increasingly severe monthly or bi-monthly UTI since infancy. Staphysagria was prescribed post a hospital stay in 2014 and as at March 2019 this lady had been UTI free for five years ‘I always had antibiotics on hand, I had cranberry pills, a Chinese remedy which I couldn’t tell you what was in it, Ural, and D-Mannose supplement – just ludicrous to think about that now!’³⁷

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Asymptomatic bacteriuria is the presence of bacteria in the urine without accompanying symptoms.

My 2019 paper Drugs, Dysbiosis and the Bowel Nosodes³⁸ included an outline of a case of a twenty-eight weeks pregnant woman presenting with asymptomatic bacteriuria (E. coli moderate numbers seen) after a prescription of Mutabile ‘staff were intrigued to hear I only took homoeopathic medicine.’

N.B. Most pregnant women get UTIs, and it is recommended to get the infection treated to avoid teratogenic disease. Therefore, it is advisable to take antibiotics; however, they occasionally have teratogenic effects and may be hazardous to the developing embryo. A few complementary therapies must be used in such cases, with homoeopathy being the best.³⁹

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‘In contrast to frequent claims, the available Meta Analyses of homoeopathy in placebo-controlled randomised trials for any indication show significant positive effects beyond placebo. Compared to other medical interventions, the quality of evidence for efficacy of homoeopathy was similar or higher than for 90% of interventions across medicine. Accordingly, the efficacy evidence from placebo-controlled randomised trials provides no justification for regulatory or political actions against homoeopathy in health-care systems.’⁴⁰

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3. Williamson DA, Roos RF, Verrall A. 2016. Antibiotic Consumption in New Zealand, 2006–2014. Prepared for the Ministry of Health. Porirua: Institute of Environmental Science and Research Ltd. Available from: https://surv.esr.cri.nz/PDF_surveillance/AntibioticConsumption/2014/Antibiotic_Consumption_Report_Final. pdf

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9. Chandra et al., 2020. Promising Roles of Alternative Medicine and Plant-Based Nanotechnology as Remedies for Urinary Tract Infections. Molecules [online]. Nov 28;25(23):5593. https://pubmed.ncbi.nlm.nih.gov/33260701/

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15. Munshi et al., 2021. In-Vitro Evaluation of Antimicrobial Activities of Escherichia coli, Klebsiella pneumoniae, Salmonella typhi, Neisseria gonorrhoeae, and Candida albicans Nosodes. Homeopathy [online]. May 21. https://pubmed.ncbi.nlm.nih.gov/34020481/

16. Pannek et al., 2018. In Vitro Effects of Homeopathic Drugs on Cultured Escherichia coli. Homeopathy [online]. May;107(2):150-154. https://pubmed.ncbi.nlm.nih.gov/29566404/

17. Jaguezeski et al., 2021. Daily intake of a homeopathic agent by dogs modulates white cell defenses and reduces bacterial counts in feces. Microbial Pathogenesis [online]. Jul;156:104936. https://pubmed.ncbi.nlm.nih.gov/33951540/

18. Jaguezeski et al., 2020. Daily consumption of a homeopathic product decreases intestinal damage and stool bacterial counts in mice challenged with Escherichia coli. Microbial Pathogenesis [online]. Oct;147:104269. https://pubmed.ncbi.nlm.nih.gov/32439564/

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20. Fortuoso et al., 2018. Homeopathic treatment as an alternative prophylactic to minimize bacterial infection and prevent neonatal diarrhea in calves. Microb Pathog. Jan;114:95-98. Available from: https://www.researchgate.net/publication/321280531_Homeopathic_treatment_as_an_alternative_prophylactic_to_minimize_bacterial_infection_and_prevent_neonatal_diarrhea_in_calves

21. Fortuoso et al., 2019. Reduction of stool bacterial counts and prevention of diarrhea using an oral homeopathic product in newborn lambs. Microb Pathog. Feb;127:347-351. Available from: https://pubmed.ncbi.nlm.nih.gov/30553908/

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29. Hamre HJ, Glockmann A, von Ammon K, Riley DS, Kiene H. 2023. Efficacy of homoeopathic treatment: Systematic review of meta-analyses of randomised placebo-controlled homoeopathy trials for any indication. Syst Rev. Oct 7;12(1):191. Available from: https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-023-02313-2#Abs1

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33. Pannek et al., 2019. Usefulness of classical homeopathy for the prophylaxis of recurrent urinary tract infections in individuals with chronic neurogenic lower urinary tract dysfunction. The Journal of Spinal Cord Medicine [online]. Jul;42(4):453-459. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6718136/

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Drugs, Dysbiosis and The Bowel Nosodes

39. Tannupriya, 2023. A review on traditional natural compounds and conventional methods for the treatment of UTI. URINE. 5(23):13-22. Available from: https://www.researchgate.net/publication/370595557_A_review_on_traditional_natural_compounds_and_conventional_methods_for_the_treatment_of_UTI#pfa

40. Hamre HJ, Glockmann A, von Ammon K, Riley DS, Kiene H. Efficacy of homoeopathic treatment: Systematic review of meta-analyses of randomised placebo-controlled homoeopathy trials for any indication. Systematic Rev. 2023 Oct 7;12(1):191. https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-023-02313-2#Abs1