Homeopathy & Urinary Tract Infection

It has been estimated that antibiotic-resistant UTIs could cost Australia A$1.6 billion per year...

Urinary tract infection (UTI) is an infection of the urinary system, which consists of the kidneys, the ureters, the bladder and the urethra. UTI affects approximately 12–15% of women every year, 50% of women before 32years of age,(1) and has been estimated to affect 40% of women during their lifetime.(2) Common symptoms of UTI include lower abdominal pain, stress and which can significantly affect quality-of-life.(3) Although unconfirmed, men seem less prone to UTI(4) which lead to poorer health outcomes when accompanied by comorbidities.(5) UTIs are classified as recurrent (R-UTIs) if there are two or more within six months, or three or more in one year.(6)

Called cystitis when located in the bladder, UTI is classified as uncomplicated when there are no abnormalities of the urinary tract, no kidney involvement, and no existing disease which would promote the UTI. The most common cause of UTI are the following bacteria: Escherichia coli (E. coli), Klebsiella spp, Proteus spp., Pseudomonas spp., Enterococcus faecalis, Staphylococcus aureus, Citrobacter spp., Morganella sp., Providencia sp., Serratia sp., Mycoplasma sp., etc.(7) E. coli, implicated in 50% of Australian UTIs,(8) followed by Klebsiella spp are the microorganisms most frequently detected.(9) Asymptomatic bacteriuria is the presence of bacteria in the urine without accompanying symptoms.(10) Noninfectious cystitis can be due to a variety of causes and may even be idiopathic in nature such as interstitial cystitis.(11)  

The annual direct cost for UTIs in Australia is approximately AUD 909 million,(3) and hospital admissions due to E. coli induced UTI estimated to cost AUD 2.3 million annually,(8) uropathogenic antimicrobial resistance,(12) particularly in E. coli, rose steadily during 2013–2017(13) and is now a major problem associated with effective UTI treatment.(9) Trimethoprim, routinely prescribed in Australia for uncomplicated UTI,(14) has rising rates of resistance,(15) with a 34% rise in resistance detected in UK samples in 2016 alone.(16) There is a pressing need for novel antimicrobial treatments.(9)

Bactericidal effects of homeopathic medicines against Escherichia coli have been observed in vitro,(17-19) and in animal models.(20,21) Until recently it was thought that homeopathic medicines were inactive dilutions beyond Avogadro's number (<1023), but biological activity and proprieties of the initial source material are retained,(22-24) hormetic activation has been observed,(25) and distinct promotion of B-cell activity has been shown,(26,27) in infection control(28) with Th1 promotion by homeopathic medicine enabling a more efficient inflammatory response, leading to resolution of disease.(29)

A change in the clinical use of antibiotics and recognition of the importance in promotion of a patient’s own innate immune system should be important considerations in combating antimicrobial resistance.(30)

Public health regulation framing the practice and use of homeopathy in Australia is legally supported by the Therapeutic Goods Act of 1989;(31) which is used by 6.8% of Australian adults.(32) Despite Australia having some of the highest rates of complementary medicine (CM) utilisation in the developed world,(33) just 0.14% of the Australian research budget was spent on CM in 2012.(34) In 2015, Australia's National Health & Medical Research Council concluded no reliable evidence for homeopathy in their homeopathy review,(35) which concealed the existence of an earlier 2012 review and contained numerous instances of bias, procedural and scientific misconduct,(34) while also excluding any homeopathy research experts.(36)   

Homeopathy is a therapeutic medical system based on the theory ‘like with like’ - that disease can be addressed via the use of the substance which produces similar symptoms to the disease.(37) Homeopathy is a hotly debated but often used medical intervention which can significantly improve Quality of Life.(38-40)Utilizing substances sourced from nature i.e., minerals, and plants, homeopathic medicines pass through a dilution process called potentization.(41)

Although bactericidal effect via homeopathic medicine has been shown,(17-21,42) this is not in accordance with the general principles of homeopathy with its hypothesis that homeopathic medicines affect the host, by, for example, activating the immune system to prevent adhesion of bacteria to the urinary tract, rather than by direct bactericidal or bacteriostatic effects.(43)

Individualized homeopathy (IH) outlines the process whereby a single homeopathic medicine is chosen based on the totality of signs and symptoms of an individual,(44) that is, concomitant conditions and diseases, psychological features and feelings, all inform the homeopathic prescription(45) – no generalized homeopathic medicine for UTI exists.(46)

Theoretically, IH can mitigate recurring infections(47) and has been shown to reduce recurring R-UTI,(46) and recurring upper respiratory tract infections.(45,48) Retrospective case series have also shown IH to be an effective approach in the management of antibiotic-resistant R-UTIs,(30) and able to reduce the frequency of R-UTIs and antibiotic use in women.(49)

Gaertner et al. (49) reported on four Swiss outpatients experiencing R-UTI for more than 10 years, who had had more than 10 courses antibiotic (AB) drugs during the preceeding 12 months. Each presented with a history of R-UTI lasting an average of 13.5 years (range 6–20), with all reporting increased frequency of UTI episodes, occurring at least monthly over the preceding 10 months, and 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 frequency of episodes with urinary tract infection as well as of antibiotic treatment was documented. Additionally, the patients were asked to assess the treatment outcome retrospectively in a validated questionnaire. Modified Naranjo Criteria were assessed independently by all authors post hoc.(50) Approval from the local ethical committee was obtained and written informed consent was obtained by all patients. Reporting was orientated following the HOM-CASE guidelines.(51) 

Chand and Kapoor(30) published intervention for two women with R-UTI which integrated treatment with a non-conventional and tailor-made homeopathy regimen, addressing multiple levels of disease simultaneously, for the prevention of recurrence as well as for treatment. Assessment of causal attribution of homeopathy treatment effect was carried out using the Modified Naranjo Criteria.

Pannek et al.,(52) studied patients with a neurogenic lower urinary tract dysfunction due to Spinal Cord Injury suffering R-UTI were offered additional homoeopathic care as add‑on to standard urologic care. Eight patients were followed up for a median period of 15 months. Five patients remained free of UTI, whereas UTI frequency was reduced in three patients.

It has been estimated that antibiotic-resistant UTIs could cost Australia A$1.6 billion per year(53)…

Sarah Penrose BSc(hons)Hom can be contacted at goodhealthforgreatlife.com

References

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53 https://theconversation.com/rising-antibiotic-resistance-in-utis-could-cost-australia-1-6-billion-a-year-by-2030-heres-how-to-curb-it-149543