A prospective case series exploring the role of Chinese herbal medicine in the treatment of recurrent urinary tract infections

• DOI: 10.1016/j.eujim.2012.05.004
• Publication Date: 2012-06-23T05:19:21Z
• Authors: Andrew Flower; George Lewith
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

Abstract Background Recurrent urinary tract infections (RUTIs) are common in women and are associated with considerable morbidity and health care costs. Antibiotic prophylaxis is currently successful but infections commonly reoccur and bacterial resistance is an increasing problem. Preliminary data suggests that Chinese herbal medicine (CHM) may have a role to play in managing RUTIs. CHM is a complex intervention that requires a thoughtful process of evaluation and testing. A prospective case series can be used to report ‘real world’ treatment using CHM and to investigate the feasibility of more rigorous research. Methods Fifteen women with RUTIs seen in routine clinical care by an experienced practitioner over a 6-month period were enrolled in a prospective case series. Treatment involved concentrated CHM powders for 12 weeks. Data was collected on common patterns of presentation, and participant response to CHM including compliance, overall changes in urinary tract symptoms, the frequency and severity of recurrent infection; change in use of antibiotics; and wellbeing. Results Thirteen out of 14 participants who completed the course of treatment reported improvement in their symptoms and overall wellbeing. Antibiotic use declined. It was possible to detect common diagnostic patterns. Conclusion A case series can explore the routine delivery of an intervention and provide information on feasibility for future research. It provided a useful opportunity to introduce case record forms, to assess various outcome measures, to gain an idea of common diagnostic presentations, to assess the safety of CHM, and to explore different treatment strategies. It facilitated the identification of commonly used herbs in the treatment of RUTIs ( Fig. 2 ) and allowed preliminary assessment of a standardised herbal formula for treatment of an acute UTI. However a case series lacks experimental rigour and is subject to considerable bias. The findings from this approach should be interpreted cautiously and seen as preliminary data that can help to inform subsequent more rigorous research.