Fruits and vegetables are the primary dietary sources of quercetin, particularly citrus fruits, apples, onions, parsley, sage, tea, and red wine.

Olive oil, grapes, dark cherries, and dark berries such as blueberries, blackberries, and bilberries are also high in quercetin and other flavonoids. Quercetin supplements are available as pills or capsules. They are often packaged with bromelain an enzyme found in pineapple because both are anti-inflammatories.

Other flavonoid-rich extracts include those from grapeseed, bilberry, Ginkgo biloba , and green tea. There are also water-soluble forms of quercetin available, such as hesperidin-methyl-chalcone HMC or quercetin-chalcone. Quercetin is generally considered safe.

Side effects may include headache and upset stomach. Preliminary evidence suggests that a byproduct of quercetin can lead to a loss of protein function.

Very high doses of quercetin may damage the kidneys. You should take periodic breaks from taking quercetin. If you are being treated with any of the following medications, you should not use quercetin supplements without talking to your health care provider first.

There is some concern that quercetin may reduce the effectiveness of certain antibiotics. Speak with your doctor. Quercetin may enhance the effect of these drugs, increasing your risk for bleeding. Anticoagulants include:.

Test tube and animal studies suggest that quercetin may enhance the effects of doxorubicin and cisplatin, which are two chemotherapy medications used to treat cancer. In addition, some doctors believe taking antioxidants at the same time as chemotherapy can be harmful, while others believe it can be helpful.

In one study, combining quercetin with the anti-tumor drug doxorubicin, increased the drug's beneficial effects on breast cancer cells. In another, taking quercetin alongside cisplatin reduced the medicines' therapeutic effects in ovarian cancer cells. Talk to your oncologist before taking any supplements if you are undergoing chemotherapy.

Quercetin may interfere with the body's absorption of this drug, which is used to suppress the immune system. Since quercetin affects the liver, concomitant use with medications that are changed by the liver may alter how the body metabolizes these medications.

Speak with your physician. Boots AW, Haenen GR, Bast A. Health effects of quercetin: from antioxidant to nutraceutical. Eur J Pharmacol. Boots AW, Li H, Schins RP, Duffin R, Heemskerk JW, Bast A, Haenen GR. The quercetin paradox. Toxicol Appl Pharmacol. Cai J, Nelson KC, Wu M, Sternberg P Jr, Jones DP.

Oxidative damage and protection of the RPE. Prog Retin Eye Res. Chan MM, Mattiacci JA, Hwang HS, Shah A, Fong D. Synergy between ethanol and grape polyphenols, quercetin, and resveratrol, in the inhibition of the inducible nitric oxide synthase pathway.

Bio Pharm. Chuang CC, Martinez K, Xie G, et al. Quercetin is equally or more effective than resveratrol in attenuating tumor necrosis factor-{alpha}-mediated inflammation and insulin resistance in primary human adipocytes. Am J Clin Nutr. Dajas F. Life or death: neuroprotective and anticancer effects of quercetin.

J Ethnopharmacol. Dower JI, Geleijnse JM, Gijsbers L, Zock PL, Kromhout D, Hollman PC. Effects of the pure flavonoids epicatechin and quercetin on vascular function and cariometabolic health: a randomized, double-blind, placebo-controlled, crossover trial.

Edwards RL, Lyon T, Litwin SE, Rabovsky A, Symons JD, Jalili T. Quercetin reduces blood pressure in hypertensive subjects. J Nutr. Egert S, Bosy-Westphal A, Seiberl J, et al. Quercetin reduces systolic blood pressure and plasma oxidised low-density lipoprotein concentrations in overweight subjects with a high-cardiovascular disease risk phenotype: a doule-blinded, placebo-controlled cross-over study.

Br J Nutr. Gates MA, Tworoger SS, Hecht JL, De Vivo I, Rosner B, Hankinson SE. A prospective study of dietary flavonoid intake and incidence of epithelial ovarian cancer.

Int J Cancer. Giuliani C, Noguchi Y, Harii N, Napolitano G, Tatone D, Bucci I, Piantelli M, Monaco F, Kohn LD. The flavonoid quercetin regulates growth and gene expression in rat FRTL-5 thyroid cells. Guardia T, Rotelli AE, Juarez AO, Pelzer LE. Anti-inflammatory properties of plant flavonoids.

Effects of rutin, quercetin, and hesperidin on adjuvant arthritis in rat. Hanninen, Kaartinen K, Rauma AL, Nenonen M, Torronen R, Hakkinen AS, Adlercreutz H, Laakso J.

Antioxidants in vegan diet and rheumatic disorders. Harwood M, Danielewska-Nikiel B, Borzelleca JF, Flamm GW, Williams GM, Lines TC. Food Chem Toxicol. Kleemann R, Verschuren L, Morrison M, et al.

Anti-inflammatory, anti-proliferative and anti-atherosclerotic effects of quercetin in human in vitro and in vivo models. Knekt P, Isotupa S, Rissanen H, Heliovaara M, Jarvinen R, Hakkinen S et al.

Quercetin intake and the incidence of cerebrovascular disease. Eur J Clin Nut. Kurowska EM, Spence JD, Jordan J, Wetmore S, Freeman DJ, Piche LA, Serratore P.

HDL-cholesterol-raising effect of orange juice in subjects with hypercholesterolemia. Lam TK, Rotunno M, Lubin JH, et al. Dietary quercetin, quercetin-gene interaction, metabolic gene expression in lung tissue and lung cancer risk.

Lamson DW, Brignall MS. Antioxidants and cancer III: quercetin. Alt Med Rev. Li N, Sun C, Zhou B, et al. Low concentration of quercetin antagonizeds the cytotoxic effects of anti-neoplastic drugs in ovarian cancer. PLoS One. Longanga OA, Vercruysse A, Foriers A. Contribution to the ethnobotanical, phytochemical and pharmacological studies of traditionally used medicinal plants in the treatment of dysentery and diarrhoea in Lomela area, Democratic Republic of Congo DRC.

Mackraj I, Govender T, Ramesar S. The antihypertensive effects of quercetin in a salt-sensitive model of hypertension. J Cardiovasc Pharmacol. Maso V, Calgarotto AK, Franchi GC, et al. Multitarget effects of quercetin in leukemia.

Cancer Prev Res Phila. Otshudi AL, Foriers A, Vercruysse A, Van Zeebroeck A, Lauwers S. In vitro antimicorbial activity of six medicinal plants traditionally used for the treatment of dysentery and diarrhoea in Democratic Republic of Congo DRC.

Owen RW, Giacosa A, Hull WE, Haubner R, Spiegelhalder B, Bartsch H. Various studies have been conducted to show the efficacy of vitamin C in the management of UTIs. Yousefichaijan et al. studied the efficacy of vitamin C supplementation on UTI in children for 14 days.

The results showed that vitamin C supplementation was able to control the symptoms of UTI, including dysuria, fever, urinary urgency, and also dribbling urine [ 59 ]. Ochoa et al. investigated the role of a daily intake of vitamin C for its effect on UTIs during pregnancy. They showed that daily usage of vitamin C has significant effects on the reduction of UTIs and also improving the health level of the women [ 60 ].

The formation of struvite stones is associated with UTIs by urease-producing bacteria. It was shown that the vitamin can modulate the struvite crystal formation in the presence of uropathogenic bacteria [ 61 ]. In another study, the combination of cranberries, a probiotic Lactobacillus rhamnosus , and vitamin C has been used to evaluate the clinical benefits due to their additive or synergistic effects.

The results showed that the approach might represent a safe and effective option in UTI management [ 62 ]. It was shown that nitrite may be generated by bacteria in urine during UTI. Acidification of nitrite leads to the formation of nitric oxide NO and other reactive nitrogen oxides that are toxic for a wide range of microorganisms.

In a study, NO formation and bacterial growth in mildly acidified urine containing nitrite and vitamin C as a reducing agent were investigated. The growth of bacteria was markedly reduced by the addition of nitrite to acidified urine.

Additionally, the inhibition was enhanced by vitamin C. These results help to explain the bacteriostatic effects of acidified nitrite because of the release of NO and other toxic reactive nitrogen intermediates and also the role of vitamin C in the treatment and prevention of UTI [ 63 ].

The positive role of vitamin A supplementation in the prevention and treatment of UTI has been mentioned previously [ 64 ]. Vitamin A has been used in the management of UTIs in children.

The results of the study indicated that in the group of the children who received , IU of the vitamin in combination with antibiotics, the incidence of UTIs was lower than the control group [ 65 ].

In another study, vitamin A supplementation in addition to antimicrobial therapy was used to improve UTI symptoms and preventing renal scarring in girls who suffer from acute pyelonephritis. The results showed that vitamin A supplementation is an effective approach for improving the clinical symptoms of UTI and also reducing the renal injury and scarring following acute pyelonephritis [ 66 ].

Sobouti et al. studied the effects of vitamin A or E supplementation in addition to antimicrobial therapy for the prevention of renal scarring in acute pyelonephritis. According to the results, vitamins A or E supplements were effective in reducing renal scarring secondary to acute pyelonephritis [ 67 ].

The other study was conducted to determine the effect of vitamin A supplementation on the rate of permanent renal damage in children with acute pyelonephritis. It was demonstrated that the administration of vitamin A leads to a significant reduction in permanent renal damage [ 68 ].

Different mechanisms have been mentioned for the implication of vitamin D on the management of UTI. It was shown that tight junction proteins play important roles in preventing the bacterial invasion of the epithelial barrier and supplementation with vitamin D could strengthen the urinary bladder lining and restore the bladder epithelial integrity [ 69 ].

Additionally, on the one hand, vitamin D could act as a local immune response mediator in UTI and on the other hand, enhancing vitamin D levels leads to modulate the innate immune system and provides a protective response to infection [ 70 , 71 ]. The relation between the status serum level of vitamin D and the risk of UTI has been studied extensively, and the results showed a significant association between increased risk of UTI and vitamin D insufficiency, as an independent risk factor, especially in children [ 72 , 73 , 74 ].

Women with vitamin D deficiencies show a higher risk level of UTI during pregnancy [ 75 ]. Vitamin D deficiency is common and the proven risk factor for UTIs especially in girls and supplementation with vitamin D could prevent first-time UTI [ 76 ].

In a randomized clinical trial, the subjects who received vitamin D3 20, IU per week for five years showed better prevention against UTI [ 77 ]. Together, these results demonstrate that vitamin D supplementation provides a potent weapon in the prevention of UTI.

The role of zinc in the management of the infectious disease has been described extensively [ 17 , 78 ]. It was shown that the element increases the response to treatment in many infections and active against different pathogens such as E. coli , Mycobacterium tuberculosis , Salmonella typhi, and Streptococcus pyogenes [ 79 , 80 , 81 ].

The incidence of zinc deficiency in infectious disease clinics has been reported extensively [ 82 , 83 ]. The results of the Mohsenpour et al. study showed that serum zinc levels in people with recurrent UTI were lower than those in the control group.

So, the zinc level could be assumed as a risk factor for recurrent UTI [ 84 ]. In another study, the relation between serum zinc levels in children inflicted with UTI and the control group was assessed. According to the data, lower zinc levels were associated with susceptibility to UTI, and therefore, zinc administration has been suggested [ 85 ].

Microbial infections are often associated with selenium deficiencies. The main physiological properties of this micronutrient are directly attributed to its presence within selenoproteins [ 11 ].

Selenium at a certain concentration was effective in preventing uropathogenic E. coli biofilm formation on urinary catheters. Further, the inhibitory effects were associated with a reduction in EPS production and gene expression of the bacteria.

Additionally, at higher concentrations, selenium was effective in inactivating preformed bacterial biofilms on catheters within 3 days of incubation. These observations suggested that selenium could be potentially used in the control of bacterial biofilms on the catheters [ 86 ].

Also, it was shown that selenium-containing analogs of L-proline and L-cystine are effective in the treatment of UTI [ 87 ].

A study was conducted to compare the blood level of retinol and selenium in a person who suffered from minor lower urinary lesions. The results showed that there was a significant difference in the mean blood level of selenium between cases and control groups [ 88 ].

Copper, Cu, is an essential micronutrient for optimal innate immune function, and the nutritional deficiency of this element leads to increased susceptibility to bacterial infections [ 11 ]. During clinical UTI, uropathogenic E. coli upregulated the expression of copper efflux genes in patients.

And, this element as a host effector could be involved in protection against pathogen colonization of the urinary tract [ 89 ]. Moreover, Cu export transport in bacteria has been addressed as an important virulence and fitness determinants during UTI [ 90 ].

Copper supplementation in drinking water has been suggested as an effective approach to reducing E. coli colonization in the urinary bladder of the animal model [ 91 ].

Citrate salts could be used in the management of UTI due to their ability to alkalinize the urine, and alkaline urine is helpful for UTI symptoms such as dysuria. It was shown that by the administration of sodium citrate in women with UTI problems for 48 h, the symptoms were significantly improved in 80 percent of the subjects [ 92 ].

Additionally, alkalinity in the urine provides an effective environment for some of the antimicrobial agents such as uva-ursi and berberine to perform their function [ 37 ].

The role of these salts in the treatment of urinary candidiasis has been mentioned in an earlier study [ 93 ]. Simple sugars such as D-mannose could prevent the adherence of pathogens to uroepithelial cells.

Various evidences show that the implementation of mannose exerts beneficial results in the treatment of UTI.

It was shown that a mannose-specific lectin exists on the surface of adherent strains of E. coli and the sugar acts as the primary bladder cell receptor site for UPEC to bind [ 94 ]. Likewise, it was reported that in the adhesion of UPEC to the uroepithelial cells, the first step is the binding of FimH adhesin to the bladder epithelium through the interaction of mannose moieties with the host cell surface [ 95 ].

So, the use of the sugar or its analogs can help to block the adhesion of E. coli to the bladder epithelium. The efficacy of these sugars in controlling UTI has been studied previously [ 96 , 97 , 98 ].

An in vivo study indicated that demonstrated D-mannose in mice not only blocked adhesion of E. coli to the epithelium of the urinary tract but also prevent bacterial invasion and biofilm formation [ 99 ].

Also, in the presence of D-mannose, the adherence of clinical isolates of E. coli was inhibited remarkably [ ]. Oral supplementation of D-mannose decreases the perception of lower urinary tract symptoms in postmenopausal women [ ].

The results of another study indicated that D-mannose efficiently blocked the adhesive properties of all type 1 fimbriae-positive isolates of E. coli in low concentration, but did not show any bacteriostatic effects [ ].

The results of another study demonstrated that antibiotic therapy in combination with long-term enrichment of the diet with D-mannose leads to prolongation of the inter-relapse period of uncomplicated UTI [ 97 ]. The effects of different derivatives of the sugar in the control of UTIs were studied.

Klein et al. synthesized and evaluated the efficacy of these sugars in blocking bacterial-host interaction. Among them, para-substituted biphenyl derivative was the most effective agent in controlling UTIs. Following oral administration of this compound, bacterial numbers were reduced by twofold and fourfold in the urine and bladder, respectively [ ].

Probiotics are living microorganisms which when administered in certain numbers exert a health benefit on the host [ ].

The clinical efficacy of probiotics for adjunct treatment in the treatment of different gastrointestinal and urinary tract infections has been addressed previously [ ].

They have demonstrated positive effects in the treatment and prevention of rotavirus diarrhea and alleviation of the antibiotic-associated intestinal adverse effects by recognizing the commensal microbiota and also restoration of the microbial ecosystem after an imbalance or infection [ ].

Probiotics are clinically proven to be effective in the management of UTI including accelerating recovery after UTI and also decreasing recurrent UTI in children [ ]. These positive effects of probiotics might be attributed to the intrinsic properties of microorganisms.

Besides these advantages, probiotics could produce biosurfactants that inhibit the growth of uropathogens by reducing the adhesion of the pathogens to the uroepithelium.

Moreover, lactobacilli could co-aggregate with uropathogens and block their adhesion to the urinary tract and also displace previously adherent uropathogens from uroepithelium. This process can create a microenvironment in which the inhibitory products of lactobacilli can concentrate on the pathogens and therefore inhibit the pathogens [ ].

It is worth noting that the most effective lactobacilli for controlling UTI are L. rhamnosus GR-1 and L. reuteri B and RC which have been proven [ ]. The common vaginal Lactobacillus species were used to investigate the inhibition of E.

coli growth. The results showed that when L. crispatus was incubated with clinical E. coli strains, the growth of E. coli was inhibited in the acidic environment [ ].

Wolff et al. The physicochemical cell surface, adhesion properties, and the antagonistic activity of recombinant Lactococcus lactis containing the Ama r 2 gene against the E. coli causing UTI in humans were studied.

The results indicated that this recombinant probiotic showed desirable properties and the Ama r 2 gene expression did not affect the positive probiotic properties [ ]. The ability of a clinically isolated probiotic, L. fermentum strain 4—17, to adhere to human intestinal was studied. fermentum strain 4—17 showed appropriate anti-adhesive properties against human pathogenic bacteria [ ].

Osset et al. Among them, L. crispatus could block pathogen adhesion efficiently. The results of another study revealed that a pyelonephritic E. coli was sensitive to L. rhamnosus , Bifidobacterium lactis, and Bifidobacterium longus and these probiotics were able to suppress the growth of enteric and urinary pathogens [ ].

Oral administration of multispecies probiotic formulations showed antimicrobial activities against the pathogens that are responsible for vaginal dysbiosis and infections [ ].

The effects of vaginal suppositories of probiotics for the prevention and treatment of UTI have been studied previously. The Lactobacillus strains inhibited the growth of E.

coli via the production of organic acids. Additionally, the adhesion and internalization of E. coli into HeLa cells were reduced by probiotics [ ]. Reid et al. investigated the effect of probiotic lactobacilli in controlling acute UTI in women.

Based on the results, recurrence reduced remarkably in the Lactobacillus group compared to the placebo group [ ]. Taken together, the results of these aforementioned studies demonstrated the potential benefit of probiotics in controlling UTI. Additionally, site-oriented probiotic therapy has been recognized as one of the most promising therapeutic alternatives for the prevention of UTI in post-antibiotic therapy [ ].

While most clinical research showed using these natural substances represents a promising approach, further studies are needed to prove their mechanism of action and clinical effectiveness. It should be noted that formulating these substances in a single dosage form and their side effects and interactions with each other are the main limitations of developing a new formulation.

Treatment with non-antibiotic agents is a good approach to reduce the risk of incidence of UTI and also decrease the symptoms of the illness. Among these agents, natural substances, nutrients, and probiotics attract attention.

Each of these agents acts by a different mechanism, and therefore, co-formulation of them in a single dosage form maybe provides the natural formulation that is effective for both preventive and therapeutic approaches in the management of UTI.

This review was based on data extracted from published papers available in all relevant databases without limitation up to October 1, Sheerin NS, Glover EK Urinary tract infection. Medicine — Article Google Scholar.

Sheerin NS Urinary tract infection. Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J Urinary tract infections, pyelonephritis, and prostatitis. In: Harrison's principles of internal medicine, 20th edn.

McGraw-Hill Education, New York. Freire MP, Martinho L, Mendes CV, Spadão F, De Paula FJ, Nahas WC, David-Neto E, Pierrotti LC Institutional protocol adherence in the incidence of recurrent urinary tract infection after kidney transplantation.

J Glob Antimicrob Resist — Article PubMed Google Scholar. Vet Clin North Am Small Anim Pract — Article PubMed PubMed Central Google Scholar. Behzadi P Classical chaperone-usher CU adhesive fimbriome: uropathogenic Escherichia coli UPEC and urinary tract infections UTIs.

Folia Microbiol Praha. Matulay JT, Mlynarczyk CM, Cooper KL Urinary tract infections in women: pathogenesis, diagnosis, and management.

Curr Bladder Dysfunct Rep — Storme O, Tiran Saucedo J, Garcia-Mora A, Dehesa-Davila M, Naber KG Risk factors and predisposing conditions for urinary tract infection. Ther Adv Urol Asadi Karam MR, Habibi M, Bouzari S Urinary tract infection: pathogenicity, antibiotic resistance and development of effective vaccines against uropathogenic Escherichia coli.

Mol Immunol — Article CAS PubMed Google Scholar. Lane DR, Takhar SS Diagnosis and management of urinary tract infection and pyelonephritis. Emerg Med Clin North Am — Khameneh B, Iranshahy M, Vahdati-Mashhadian N, Sahebkar A, Fazly Bazzaz BS Non-antibiotic adjunctive therapy: a promising approach to fight tuberculosis.

Pharmacol Res Khameneh B, Diab R, Ghazvini K, Fazly Bazzaz BS Breakthroughs in bacterial resistance mechanisms and the potential ways to combat them. Microb Pathog — Khameneh B, Iranshahy M, Soheili V, Fazly Bazzaz BS Review on plant antimicrobials: a mechanistic viewpoint. Antimicrob Resist Infect Control Bazzaz BSF, Fakori M, Khameneh B, Hosseinzadeh H Effects of omeprazole and caffeine alone and in combination with gentamicin and ciprofloxacin against antibiotic resistant staphylococcus aureus and Escherichia coli strains.

J Pharmacopuncture — Fazly Bazzaz BS, Khameneh B, Zahedian Ostad MR, Hosseinzadeh H In vitro evaluation of antibacterial activity of verbascoside, lemon verbena extract and caffeine in combination with gentamicin against drug-resistant Staphylococcus aureus and Escherichia coli clinical isolates.

Avicenna J Phytomed — PubMed PubMed Central Google Scholar. Fazly Bazzaz BS, Sarabandi S, Khameneh B, Hosseinzadeh H Effect of catechins, green tea extract and methylxanthines in combination with gentamicin against Staphylococcus aureus and Pseudomonas aeruginosa : combination therapy against resistant bacteria.

Baker JH, Qiu J, Grine K Role of complementary and alternative therapies in infectious disease. Prim Care Clin Off Pract — Mantzorou M, Giaginis C Cranberry consumption against urinary tract infections: clinical state-of-the-art and future perspectives.

Curr Pharm Biotechnol — Poulios E, Vasios GK, Psara E, Giaginis C Medicinal plants consumption against urinary tract infections: a narrative review of the current evidence. Expert Rev Anti Infect Ther — CAS Google Scholar.

Loubet P, Ranfaing J, Dinh A, Dunyach-Remy C, Bernard L, Bruyère F, Lavigne J-P, Sotto A Alternative therapeutic options to antibiotics for the treatment of urinary tract infections.

Front Microbiol Farhadi F, Khameneh B, Iranshahi M, Iranshahy M Antibacterial activity of flavonoids and their structure-activity relationship: an update review. Phytother Res — Shaheen G, Akram M, Jabeen F, Ali Shah SM, Munir N, Daniyal M, Riaz M, Tahir IM, Ghauri AO, Sultana S, Zainab R, Khan M Therapeutic potential of medicinal plants for the management of urinary tract infection: a systematic review.

Clin Exp Pharmacol Physiol — Yarnell E Botanical medicines for the urinary tract. World J Urol — Bag A, Bhattacharyya S, Chattopadhyay R Medicinal plants and urinary tract infections: an update. Phcog Rev Google Scholar.

Marino A, Bellinghieri V, Nostro A, Miceli N, Taviano MF, Guvenc A, Bisignano G In vitro effect of branch extracts of Juniperus species from Turkey on Staphylococcus aureus biofilm. FEMS Immunol Med Microbiol — Schilcher H Juniper berry oil in diseases of the efferent urinary tract? Med Monatsschr Pharm — CAS PubMed Google Scholar.

Pepeljnjak S, Kosalec I, Kalodera Z, Blazevic N Antimicrobial activity of juniper berry essential oil Juniperus communis L. Acta Pharm — Howell AB, Foxman B Cranberry juice and adhesion of antibiotic-resistant uropathogens.

JAMA — Burger O, Ofek I, Tabak M, Weiss EI, Sharon N, Neeman I A high molecular mass constituent of cranberry juice inhibits Helicobacter pylori adhesion to human gastric mucus.

Di Martino P, Agniel R, David K, Templer C, Gaillard JL, Denys P, Botto H Reduction of Escherichia coli adherence to uroepithelial bladder cells after consumption of cranberry juice: a double-blind randomized placebo-controlled cross-over trial. Tao Y, Pinzon-Arango PA, Howell AB, Camesano TA Oral consumption of cranberry juice cocktail inhibits molecular-scale adhesion of clinical uropathogenic Escherichia coli.

J Med Food — Article CAS PubMed PubMed Central Google Scholar. LaPlante KL, Sarkisian SA, Woodmansee S, Rowley DC, Seeram NP Effects of cranberry extracts on growth and biofilm production of Escherichia coli and Staphylococcus species.

Howell AB, Reed JD, Krueger CG, Winterbottom R, Cunningham DG, Leahy M A-type cranberry proanthocyanidins and uropathogenic bacterial anti-adhesion activity. Phytochemistry — Raditic DM Complementary and integrative therapies for lower urinary tract diseases.

Dason S, Dason JT, Kapoor A Guidelines for the diagnosis and management of recurrent urinary tract infection in women. Can Urol Assoc J — Davidson E, Zimmermann BF, Jungfer E, Chrubasik-Hausmann S Prevention of urinary tract infections with Vaccinium products.

Head KA Natural approaches to prevention and treatment of infections of the lower urinary tract. Altern Med Rev — PubMed Google Scholar.

Mary Anne Roshni Amalaradjou, Venkitanarayanan K Natural approaches for controlling urinary tract infections. In: Tenke P ed Urinary tract infections. InTech, New York, pp — Int J Drug Dev Res — Geetha RV, Roy A, Lakshmi T In vitro evaluation of anti bacterial activity of leaf extract of Agathosma betulina on urinary tract pathogens.

Intl J Pharm Sci Rev Res — Rafsanjany N, Lechtenberg M, Petereit F, Hensel A Antiadhesion as a functional concept for protection against uropathogenic Escherichia coli : In vitro studies with traditionally used plants with antiadhesive activity against uropathogenic Escherichia coli.

J Ethnopharmacol — Williams G, Craig JC Prevention of recurrent urinary tract infection in children. Curr Opin Infect Dis — Mutters NT, Mampel A, Kropidlowski R, Biehler K, Günther F, Bălu I, Malek V, Frank U Treating urinary tract infections due to MDR E.

coli with Isothiocyanates—a phytotherapeutic alternative to antibiotics? Fitoterapia — Tims M, Batista C Effects of root isoquinoline alkaloids from Hydrastis canadensis on Fusarium oxysporum isolated from Hydrastis root tissue.

J Chem Ecol — Genovese C, Davinelli S, Mangano K, Tempera G, Nicolosi D, Corsello S, Vergalito F, Tartaglia E, Scapagnini G, Di Marco R Effects of a new combination of plant extracts plus d-mannose for the management of uncomplicated recurrent urinary tract infections.

J Chemother — Ceyhan N, Keskin D, Uǧur A Antimicrobial activities of different extracts of eight plant species from four different family against some pathogenic microorganisms.

J Food Agric Environ — Das G, Patra JK, Baek KH Antibacterial properties of endophytic bacteria isolated from a fern species Equisetum arvense L. against foodborne pathogenic bacteria Staphylococcus aureus and Escherichia coli OH7.

Foodborne Pathog Dis — Asgarpanah J, Roohi E Phytochemistry and pharmacological properties of Equisetum arvense L. J Med Plants Res — Radojevic ID, Stankovic MS, Stefanovic OD, Topuzovic MD, Comic LR, Ostojic AM Great horsetail Equisetum telmateia Ehrh. EXCLI J — Chrubasik JE, Roufogalis BD, Wagner H, Chrubasik SA A comprehensive review on nettle effect and efficacy profiles, part I: Herba urticae.

Phytomedicine — Kukrić ZZ, Topalić-Trivunović LN, Kukavica BM, Matoš SB, Pavičić SS, Boroja MM, Savić AV Characterization of antioxidant and antimicrobial activities of nettle leaves Urtica dioica L. Acta Periodica Technol — Balkhi TMB, Bhat FA Bioactive potential of leaf extracts from Urtica dioica L.

against fish and human pathogenic bacteria. Afr J Microbiol Res — Kreft S, Lunder M Herbal medicinal products for the treatment of the urogenital infection. Farm Vestn — Bahmani M, Saki K, Shahsavari S, Rafieian-Kopaei M, Sepahvand R, Adineh A Identification of medicinal plants effective in infectious diseases in Urmia, northwest of Iran.

Asian Pac J Trop Biomed — Shaaban MT, Ghozlan HA, El Maghraby MM Susceptibility of bacteria infecting urinary tract to some antibiotics and essential oils.

JAPS Kwiecińska-Piróg J, Skowron K, Bogiel T, Białucha A, Przekwas J, Gospodarek-Komkowska E Vitamin C in the presence of sub-Inhibitory concentration of aminoglycosides and fluoroquinolones alters Proteus mirabilis biofilm inhibitory rate. Antibiotics Article PubMed Central CAS Google Scholar.

Monroy-Torres R, Medina-Jiménez AK Cranberry juice and other functional foods in urinary tract infections in women: a review of actual evidence and main challenges.

Front Clin Drug Res Anti Infect. Yousefichaijan P, Goudarzi AA, Rezagholizamenjany M, Kahbazi M, Rafeie M, Shabestari AA, Shariatmadari F, Taherahmadi H Efficacy of ascorbic acid supplementation in relief of symptoms due to febrile upper urinary tract infection in children, a clinical trial and hospital based study.

Arch Pediatric Infect Dis 6:e Ochoa-Brust GJ, Fernandez AR, Villanueva-Ruiz GJ, Velasco R, Trujillo-Hernandez B, Vasquez C Daily intake of mg ascorbic acid as urinary tract infection prophylactic agent during pregnancy.

Acta Obstet Gynecol Scand — Manzoor MAP, Duwal SR, Mujeeburahiman M, Rekha PD Vitamin C inhibits crystallization of struvite from artificial urine in the presence of Pseudomonas aeruginosa.

Int Braz J Urol — Montorsi F, Gandaglia G, Salonia A, Briganti A, Mirone V Effectiveness of a combination of cranberries, Lactobacillus rhamnosus , and vitamin C for the management of recurrent urinary tract infections in women: results of a pilot study. Eur Urol — Carlsson S, Wiklund NP, Engstrand L, Weitzberg E, Lundberg JON Effects of pH, nitrite, and ascorbic acid on nonenzymatic nitric oxide generation and bacterial growth in urine.

Nitric Oxide Biol Chem — Article CAS Google Scholar. Yoo C, Kim CS Complementary and alternative medicine in urology. Korean J Urol — Yilmaz A, Bahat E, Yilmaz GG, Hasanoglu A, Akman S, Guven AG Adjuvant effect of vitamin A on recurrent lower urinary tract infections.

Pediatr Int — Kahbazi M, Sharafkhah M, Yousefichaijan P, Taherahmadi H, Rafiei M, Kaviani P, Abaszadeh S, Massoudifar A, Mohammadbeigi A Vitamin A supplementation is effective for improving the clinical symptoms of urinary tract infections and reducing renal scarring in girls with acute pyelonephritis: a randomized, double-blind placebo-controlled, clinical trial study.

Complement Ther Med — Sobouti B, Hooman N, Movahed M The effect of vitamin e or vitamin A on the prevention of renal scarring in children with acute pyelonephritis. Pediatr Nephrol — Ayazi P, Moshiri SA, Mahyar A, Moradi M The effect of vitamin A on renal damage following acute pyelonephritis in children.

Eur J Pediatr — Smith JM, Cancienne JM, Brockmeier SF, Werner BC Vitamin D deficiency and total shoulder arthroplasty complications.

Shoulder Elbow. Hertting O, Lüthje P, Sullivan D, Aspenström P, Brauner A Vitamin D-deficient mice have more invasive urinary tract infection. PLoS ONE e Article PubMed PubMed Central CAS Google Scholar. Ramos NL, Sekikubo M, Kironde F, Mirembe F, Sääf M, Brauner A The impact of vitamin D on the innate immune response to uropathogenic Escherichia coli during pregnancy.

Clin Microbiol Infect Deng QF, Chu H, Wen Z, Cao YS Vitamin D and urinary tract infection: a systematic review and meta-analysis.

Ann Clin Lab Sci — Handoka NM, Amin RE, Shalaby SA Vitamin D deficiency is associated with urinary tract infection in children. Arch Med Sci — Tekin M, Konca C, Celik V, Almis H, Kahramaner Z, Erdemir A, Gulyuz A, Uckardes F, Turgut M The association between Vitamin D levels and urinary tract infection in children.

Horm Res Paediatr — Haghdoost S, Pazandeh F, Darvish S, Khabazkhoob M, Huss R, Lak TB Association of serum vitamin D levels and urinary tract infection in pregnant women: a case control study.

Eur J Obstet Gynecol Reprod Biol — Georgieva V, Kamolvit W, Herthelius M, Lüthje P, Brauner A, Chromek M Association between vitamin D, antimicrobial peptides and urinary tract infection in infants and young children.

Acta Paediatr Int J Paediatr — Jorde R, Sollid ST, Svartberg J, Joakimsen RM, Grimnes G, Hutchinson MYS Prevention of urinary tract infections with vitamin D supplementation 20, IU per week for five years.

Results from an RCT including subjects. Infect Dis — Hemila H, Chalker E The effectiveness of high dose zinc acetate lozenges on various common cold symptoms: a meta-analysis.

BMC Fam Pract Consolo LZZ, Melnikov P, Cônsolo FZ, Nascimento VA, Pontes JCDV Zinc supplementation in children and adolescents with acute leukemia. Eur J Clin Nutr — Haider BA, Lassi ZS, Ahmed A, Bhutta ZA Zinc supplementation as an adjunct to antibiotics in the treatment of pneumonia in children 2 to 59 months of age.

Cochrane Datab Syst Rev J Enzyme Inhib Med Chem — Dizdar OS, Baspınar O, Kocer D, Dursun ZB, Avcı D, Karakükcü C, Çelik I, Gundogan K Nutritional risk, micronutrient status and clinical outcomes: a prospective observational study in an infectious disease clinic.

Nutrients Hamer DH, Sempértegui F, Estrella B, Tucker KL, Rodríguez A, Egas J, Dallal GE, Selhub J, Griffiths JK, Meydani SN Micronutrient deficiencies are associated with impaired immune response and higher burden of respiratory infections in elderly Ecuadorians.

J Nutr — Mohsenpour B, Ahmadi A, Baneh AM, Hajibagheri K, Ghaderi E, Afrasiabian S, Azizi S Relation between serum zinc levels and recurrent urinary tract infections in female patients: a case—control study. Med J Islam Repub Iran — Tehran Uni Med J — Narayanan A, Nair MS, Muyyarikkandy MS, Amalaradjou MA Inhibition and inactivation of uropathogenic Escherichia coli Biofilms on urinary catheters by Sodium Selenite.

Int J Mol Sci Deutch CE, Spahija I, Wagner CE Susceptibility of Escherichia coli to the toxic L-proline analogue L-selenaproline is dependent on two L-cystine transport systems.

J Appl Microbiol — Hafez AS, Fahim HI, Wafaay H, Mohamed FA A comparative study of blood retinol and selenium in minor lower urinary lesions. A case control study. J Egypt Public Health Assoc — Hyre AN, Kavanagh K, Kock ND, Donati GL, Subashchandrabose S Copper is a host effector mobilized to urine during urinary tract infection to impair bacterial colonization.

Infect Immun Subashchandrabose S, Mobley HLT Back to the metal age: battle for metals at the host-pathogen interface during urinary tract infection.

Metallomics — Subashchandrabose S, Hazen TH, Brumbaugh AR, Himpsl SD, Smith SN, Ernst RD, Rasko DA, Mobley HLT Host-specific induction of Escherichia coli fitness genes during human urinary tract infection. Proc Natl Acad Sci USA — Spooner JB Alkalinisation in the management of cystitis.

J Int Med Res — Strassner C, Friesen A Therapy of candiduria by alkalinization of urine. Oral treatment with potassium-sodium-hydrogen citrate. Fortschr Med — Firon N, Ashkenazi S, Mirelman D, Ofek I, Sharon N Aromatic alpha-glycosides of mannose are powerful inhibitors of the adherence of type 1 fimbriated Escherichia coli to yeast and intestinal epithelial cells.

Infect Immun — Schaeffer AJ Structural basis of tropism of Escherichia coli to the bladder during urinary tract infection. J Urol Scribano D, Sarshar M, Prezioso C, Lucarelli M, Angeloni A, Zagaglia C, Palamara AT, Ambrosi C D-Mannose treatment neither affects uropathogenic Escherichia coli properties nor induces stable fimh modifications.

Molecules Kuzmenko AV, Kuzmenko VV, Gyaurgiev TA Efficacy of combined antibacterial-prebiotic therapy in combination with d-mannose in women with uncomplicated lower urinary tract infection. Urologiia — Duncan D Alternative to antibiotics for managing asymptomatic and non-symptomatic bacteriuria in older persons: a review.

Brit J Community Nurs — Wellens A, Garofalo C, Nguyen H, Van Gerven N, Slattegard R, Hernalsteens JP, Wyns L, Oscarson S, De Greve H, Hultgren S, Bouckaert J Intervening with urinary tract infections using anti-adhesives based on the crystal structure of the FimH-oligomannose-3 complex.

PLoS ONE 3:e Schaeffer AJ, Chmiel JS, Duncan JL, Falkowski WS Mannose-sensitive adherence of Escherichia coli to epithelial cells from women with recurrent urinary tract infections. J Urol — Russo E, Montt Guevara M, Giannini A, Mannella P, Palla G, Caretto M, Pancetti F, Genazzani AD, Simoncini T Cranberry, D-mannose and anti-inflammatory agents prevent lower urinary tract symptoms in women undergoing prolapse surgery.

Climacteric — Marcon J, Schubert S, Stief CG, Magistro G In vitro efficacy of phytotherapeutics suggested for prevention and therapy of urinary tract infections. Infection — Klein T, Abgottspon D, Wittwer M, Rabbani S, Herold J, Jiang X, Kleeb S, Luthi C, Scharenberg M, Bezencon J, Gubler E, Pang L, Smiesko M, Cutting B, Schwardt O, Ernst B FimH antagonists for the oral treatment of urinary tract infections: from design and synthesis to in vitro and in vivo evaluation.

J Med Chem — Gorbach SL Probiotics in the third millennium. Dig Liver Dis 34 Suppl 2 :S Amdekar S, Singh V, Singh DD Probiotic therapy: immunomodulating approach toward urinary tract infection. Curr Microbiol — Marteau P, Boutron-Ruault MC Nutritional advantages of probiotics and prebiotics.

Br J Nutr 87 Suppl 2 :S Prasetyo RV, Surono I, Soemyarso NA, Djojodimedjo T, Rauf S, Noer MS, Sudarmo SM Lactobacillus plantarum IS promotes renal tubular regeneration in pyelonephritic rats. Benef Microbes — Reid G, Bruce AW Probiotics to prevent urinary tract infections: the rationale and evidence.

Petraitytė S, Šipailienė A Enhancing encapsulation efficiency of alginate capsules containing lactic acid bacteria by using different divalent cross-linkers sources. LWT — Aroutcheva A, Gariti D, Simon M, Shott S, Faro J, Simoes JA, Gurguis A, Faro S Defense factors of vaginal lactobacilli. Am J Obstet Gynecol — Mastromarino P, Brigidi P, Macchia S, Maggi L, Pirovano F, Trinchieri V, Conte U, Matteuzzi D Characterization and selection of vaginal Lactobacillus strains for the preparation of vaginal tablets.

Hudson PL, Hung KJ, Bergerat A, Mitchell C Effect of vaginal Lactobacillus species on Escherichia coli growth. Female Pelvic Med Reconstr Surg —

J Food Agric Environ — Das G, Patra JK, Baek KH Antibacterial properties of endophytic bacteria isolated from a fern species Equisetum arvense L.

against foodborne pathogenic bacteria Staphylococcus aureus and Escherichia coli OH7. Foodborne Pathog Dis — Asgarpanah J, Roohi E Phytochemistry and pharmacological properties of Equisetum arvense L. J Med Plants Res — Radojevic ID, Stankovic MS, Stefanovic OD, Topuzovic MD, Comic LR, Ostojic AM Great horsetail Equisetum telmateia Ehrh.

EXCLI J — Chrubasik JE, Roufogalis BD, Wagner H, Chrubasik SA A comprehensive review on nettle effect and efficacy profiles, part I: Herba urticae.

Phytomedicine — Kukrić ZZ, Topalić-Trivunović LN, Kukavica BM, Matoš SB, Pavičić SS, Boroja MM, Savić AV Characterization of antioxidant and antimicrobial activities of nettle leaves Urtica dioica L.

Acta Periodica Technol — Balkhi TMB, Bhat FA Bioactive potential of leaf extracts from Urtica dioica L. against fish and human pathogenic bacteria. Afr J Microbiol Res — Kreft S, Lunder M Herbal medicinal products for the treatment of the urogenital infection. Farm Vestn — Bahmani M, Saki K, Shahsavari S, Rafieian-Kopaei M, Sepahvand R, Adineh A Identification of medicinal plants effective in infectious diseases in Urmia, northwest of Iran.

Asian Pac J Trop Biomed — Shaaban MT, Ghozlan HA, El Maghraby MM Susceptibility of bacteria infecting urinary tract to some antibiotics and essential oils. JAPS Kwiecińska-Piróg J, Skowron K, Bogiel T, Białucha A, Przekwas J, Gospodarek-Komkowska E Vitamin C in the presence of sub-Inhibitory concentration of aminoglycosides and fluoroquinolones alters Proteus mirabilis biofilm inhibitory rate.

Antibiotics Article PubMed Central CAS Google Scholar. Monroy-Torres R, Medina-Jiménez AK Cranberry juice and other functional foods in urinary tract infections in women: a review of actual evidence and main challenges.

Front Clin Drug Res Anti Infect. Yousefichaijan P, Goudarzi AA, Rezagholizamenjany M, Kahbazi M, Rafeie M, Shabestari AA, Shariatmadari F, Taherahmadi H Efficacy of ascorbic acid supplementation in relief of symptoms due to febrile upper urinary tract infection in children, a clinical trial and hospital based study.

Arch Pediatric Infect Dis 6:e Ochoa-Brust GJ, Fernandez AR, Villanueva-Ruiz GJ, Velasco R, Trujillo-Hernandez B, Vasquez C Daily intake of mg ascorbic acid as urinary tract infection prophylactic agent during pregnancy. Acta Obstet Gynecol Scand — Manzoor MAP, Duwal SR, Mujeeburahiman M, Rekha PD Vitamin C inhibits crystallization of struvite from artificial urine in the presence of Pseudomonas aeruginosa.

Int Braz J Urol — Montorsi F, Gandaglia G, Salonia A, Briganti A, Mirone V Effectiveness of a combination of cranberries, Lactobacillus rhamnosus , and vitamin C for the management of recurrent urinary tract infections in women: results of a pilot study.

Eur Urol — Carlsson S, Wiklund NP, Engstrand L, Weitzberg E, Lundberg JON Effects of pH, nitrite, and ascorbic acid on nonenzymatic nitric oxide generation and bacterial growth in urine. Nitric Oxide Biol Chem — Article CAS Google Scholar.

Yoo C, Kim CS Complementary and alternative medicine in urology. Korean J Urol — Yilmaz A, Bahat E, Yilmaz GG, Hasanoglu A, Akman S, Guven AG Adjuvant effect of vitamin A on recurrent lower urinary tract infections. Pediatr Int — Kahbazi M, Sharafkhah M, Yousefichaijan P, Taherahmadi H, Rafiei M, Kaviani P, Abaszadeh S, Massoudifar A, Mohammadbeigi A Vitamin A supplementation is effective for improving the clinical symptoms of urinary tract infections and reducing renal scarring in girls with acute pyelonephritis: a randomized, double-blind placebo-controlled, clinical trial study.

Complement Ther Med — Sobouti B, Hooman N, Movahed M The effect of vitamin e or vitamin A on the prevention of renal scarring in children with acute pyelonephritis. Pediatr Nephrol — Ayazi P, Moshiri SA, Mahyar A, Moradi M The effect of vitamin A on renal damage following acute pyelonephritis in children.

Eur J Pediatr — Smith JM, Cancienne JM, Brockmeier SF, Werner BC Vitamin D deficiency and total shoulder arthroplasty complications. Shoulder Elbow. Hertting O, Lüthje P, Sullivan D, Aspenström P, Brauner A Vitamin D-deficient mice have more invasive urinary tract infection.

PLoS ONE e Article PubMed PubMed Central CAS Google Scholar. Ramos NL, Sekikubo M, Kironde F, Mirembe F, Sääf M, Brauner A The impact of vitamin D on the innate immune response to uropathogenic Escherichia coli during pregnancy. Clin Microbiol Infect Deng QF, Chu H, Wen Z, Cao YS Vitamin D and urinary tract infection: a systematic review and meta-analysis.

Ann Clin Lab Sci — Handoka NM, Amin RE, Shalaby SA Vitamin D deficiency is associated with urinary tract infection in children. Arch Med Sci — Tekin M, Konca C, Celik V, Almis H, Kahramaner Z, Erdemir A, Gulyuz A, Uckardes F, Turgut M The association between Vitamin D levels and urinary tract infection in children.

Horm Res Paediatr — Haghdoost S, Pazandeh F, Darvish S, Khabazkhoob M, Huss R, Lak TB Association of serum vitamin D levels and urinary tract infection in pregnant women: a case control study.

Eur J Obstet Gynecol Reprod Biol — Georgieva V, Kamolvit W, Herthelius M, Lüthje P, Brauner A, Chromek M Association between vitamin D, antimicrobial peptides and urinary tract infection in infants and young children.

Acta Paediatr Int J Paediatr — Jorde R, Sollid ST, Svartberg J, Joakimsen RM, Grimnes G, Hutchinson MYS Prevention of urinary tract infections with vitamin D supplementation 20, IU per week for five years.

Results from an RCT including subjects. Infect Dis — Hemila H, Chalker E The effectiveness of high dose zinc acetate lozenges on various common cold symptoms: a meta-analysis. BMC Fam Pract Consolo LZZ, Melnikov P, Cônsolo FZ, Nascimento VA, Pontes JCDV Zinc supplementation in children and adolescents with acute leukemia.

Eur J Clin Nutr — Haider BA, Lassi ZS, Ahmed A, Bhutta ZA Zinc supplementation as an adjunct to antibiotics in the treatment of pneumonia in children 2 to 59 months of age. Cochrane Datab Syst Rev J Enzyme Inhib Med Chem — Dizdar OS, Baspınar O, Kocer D, Dursun ZB, Avcı D, Karakükcü C, Çelik I, Gundogan K Nutritional risk, micronutrient status and clinical outcomes: a prospective observational study in an infectious disease clinic.

Nutrients Hamer DH, Sempértegui F, Estrella B, Tucker KL, Rodríguez A, Egas J, Dallal GE, Selhub J, Griffiths JK, Meydani SN Micronutrient deficiencies are associated with impaired immune response and higher burden of respiratory infections in elderly Ecuadorians. J Nutr — Mohsenpour B, Ahmadi A, Baneh AM, Hajibagheri K, Ghaderi E, Afrasiabian S, Azizi S Relation between serum zinc levels and recurrent urinary tract infections in female patients: a case—control study.

Med J Islam Repub Iran — Tehran Uni Med J — Narayanan A, Nair MS, Muyyarikkandy MS, Amalaradjou MA Inhibition and inactivation of uropathogenic Escherichia coli Biofilms on urinary catheters by Sodium Selenite.

Int J Mol Sci Deutch CE, Spahija I, Wagner CE Susceptibility of Escherichia coli to the toxic L-proline analogue L-selenaproline is dependent on two L-cystine transport systems. J Appl Microbiol — Hafez AS, Fahim HI, Wafaay H, Mohamed FA A comparative study of blood retinol and selenium in minor lower urinary lesions.

A case control study. J Egypt Public Health Assoc — Hyre AN, Kavanagh K, Kock ND, Donati GL, Subashchandrabose S Copper is a host effector mobilized to urine during urinary tract infection to impair bacterial colonization.

Infect Immun Subashchandrabose S, Mobley HLT Back to the metal age: battle for metals at the host-pathogen interface during urinary tract infection.

Metallomics — Subashchandrabose S, Hazen TH, Brumbaugh AR, Himpsl SD, Smith SN, Ernst RD, Rasko DA, Mobley HLT Host-specific induction of Escherichia coli fitness genes during human urinary tract infection.

Proc Natl Acad Sci USA — Spooner JB Alkalinisation in the management of cystitis. J Int Med Res — Strassner C, Friesen A Therapy of candiduria by alkalinization of urine.

Oral treatment with potassium-sodium-hydrogen citrate. Fortschr Med — Firon N, Ashkenazi S, Mirelman D, Ofek I, Sharon N Aromatic alpha-glycosides of mannose are powerful inhibitors of the adherence of type 1 fimbriated Escherichia coli to yeast and intestinal epithelial cells.

Infect Immun — Schaeffer AJ Structural basis of tropism of Escherichia coli to the bladder during urinary tract infection. J Urol Scribano D, Sarshar M, Prezioso C, Lucarelli M, Angeloni A, Zagaglia C, Palamara AT, Ambrosi C D-Mannose treatment neither affects uropathogenic Escherichia coli properties nor induces stable fimh modifications.

Molecules Kuzmenko AV, Kuzmenko VV, Gyaurgiev TA Efficacy of combined antibacterial-prebiotic therapy in combination with d-mannose in women with uncomplicated lower urinary tract infection.

Urologiia — Duncan D Alternative to antibiotics for managing asymptomatic and non-symptomatic bacteriuria in older persons: a review. Brit J Community Nurs — Wellens A, Garofalo C, Nguyen H, Van Gerven N, Slattegard R, Hernalsteens JP, Wyns L, Oscarson S, De Greve H, Hultgren S, Bouckaert J Intervening with urinary tract infections using anti-adhesives based on the crystal structure of the FimH-oligomannose-3 complex.

PLoS ONE 3:e Schaeffer AJ, Chmiel JS, Duncan JL, Falkowski WS Mannose-sensitive adherence of Escherichia coli to epithelial cells from women with recurrent urinary tract infections. J Urol — Russo E, Montt Guevara M, Giannini A, Mannella P, Palla G, Caretto M, Pancetti F, Genazzani AD, Simoncini T Cranberry, D-mannose and anti-inflammatory agents prevent lower urinary tract symptoms in women undergoing prolapse surgery.

Climacteric — Marcon J, Schubert S, Stief CG, Magistro G In vitro efficacy of phytotherapeutics suggested for prevention and therapy of urinary tract infections.

Infection — Klein T, Abgottspon D, Wittwer M, Rabbani S, Herold J, Jiang X, Kleeb S, Luthi C, Scharenberg M, Bezencon J, Gubler E, Pang L, Smiesko M, Cutting B, Schwardt O, Ernst B FimH antagonists for the oral treatment of urinary tract infections: from design and synthesis to in vitro and in vivo evaluation.

J Med Chem — Gorbach SL Probiotics in the third millennium. Dig Liver Dis 34 Suppl 2 :S Amdekar S, Singh V, Singh DD Probiotic therapy: immunomodulating approach toward urinary tract infection. Curr Microbiol — Marteau P, Boutron-Ruault MC Nutritional advantages of probiotics and prebiotics.

Br J Nutr 87 Suppl 2 :S Prasetyo RV, Surono I, Soemyarso NA, Djojodimedjo T, Rauf S, Noer MS, Sudarmo SM Lactobacillus plantarum IS promotes renal tubular regeneration in pyelonephritic rats.

Benef Microbes — Reid G, Bruce AW Probiotics to prevent urinary tract infections: the rationale and evidence. Petraitytė S, Šipailienė A Enhancing encapsulation efficiency of alginate capsules containing lactic acid bacteria by using different divalent cross-linkers sources.

LWT — Aroutcheva A, Gariti D, Simon M, Shott S, Faro J, Simoes JA, Gurguis A, Faro S Defense factors of vaginal lactobacilli. Am J Obstet Gynecol — Mastromarino P, Brigidi P, Macchia S, Maggi L, Pirovano F, Trinchieri V, Conte U, Matteuzzi D Characterization and selection of vaginal Lactobacillus strains for the preparation of vaginal tablets.

Hudson PL, Hung KJ, Bergerat A, Mitchell C Effect of vaginal Lactobacillus species on Escherichia coli growth. Female Pelvic Med Reconstr Surg — Wolff BJ, Price TK, Joyce CJ, Wolfe AJ, Mueller ER Oral probiotics and the female urinary microbiome: a double-blinded randomized placebo-controlled trial.

Int Urol Nephrol — Vasiee A, Mortazavi SA, Sankian M, Yazdi FT, Mahmoudi M, Shahidi F Antagonistic activity of recombinant Lactococcus lactis NZ on the adhesion properties of Escherichia coli causing urinary tract infection.

Microb Pathog Falah F, Vasiee A, Behbahani BA, Yazdi FT, Moradi S, Mortazavi SA, Roshanak S Evaluation of adherence and anti-infective properties of probiotic Lactobacillus fermentum strain 4—17 against Escherichia coli causing urinary tract infection in humans. Osset J, Bartolome RM, Garcia E, Andreu A Assessment of the capacity of Lactobacillus to inhibit the growth of uropathogens and block their adhesion to vaginal epithelial cells.

J Infect Dis — Hutt P, Shchepetova J, Loivukene K, Kullisaar T, Mikelsaar M Antagonistic activity of probiotic lactobacilli and bifidobacteria against entero- and uropathogens. Mezzasalma V, Manfrini E, Ferri E, Boccarusso M, Di Gennaro P, Schiano I, Michelotti A, Labra M Orally administered multispecies probiotic formulations to prevent uro-genital infections: a randomized placebo-controlled pilot study.

Arch Gynecol Obstet — Leccese Terraf MC, Juarez Tomás MS, Rault L, Le Loir Y, Even S, Nader-Macías MEF In vitro effect of vaginal lactobacilli on the growth and adhesion abilities of uropathogenic Escherichia coli.

Arch Microbiol — Reid G, Bruce AW, Taylor M Influence of three-day antimicrobial therapy and Lactobacillus vaginal suppositories on recurrence of urinary tract infections.

Clin Ther — Download references. Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.

Department of Pharmaceutical Control, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.

Department of Family Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. You can also search for this author in PubMed Google Scholar. BK collaborated in the original idea, concept, design, and writing and drafting the article.

SDF and RA contributed to data interpretation, writing, and drafting of the article. BSFB contributed to all stages of the process and mainly participated in drafting the article, writing, and editing the final version to be published.

All the authors read and approved the final version of the manuscript. Correspondence to Bahman Khameneh. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Open Access This article is licensed under a Creative Commons Attribution 4. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material.

If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Reprints and permissions.

Fazly Bazzaz, B. et al. Deep insights into urinary tract infections and effective natural remedies. Afr J Urol 27 , 6 Download citation. Received : 21 October Accepted : 25 December Published : 07 January Anyone you share the following link with will be able to read this content:.

Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all SpringerOpen articles Search. Download PDF.

Abstract Background Urinary tract infection UTI is a common occurrence in females, during pregnancy, and in peri- and postmenopausal women.

Main body Different databases were employed to identify studies reporting on natural options including herbal medicines, vitamins, trace elementals, sugars, and probiotics without time limitations.

Conclusion Herbal medicines can be effective at the first sign of the infection and also for short-term prophylaxis. Full size image. Availability of data and materials This review was based on data extracted from published papers available in all relevant databases without limitation up to October 1, References Sheerin NS, Glover EK Urinary tract infection.

Medicine — Article Google Scholar Sheerin NS Urinary tract infection. Medicine — Article Google Scholar Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J Urinary tract infections, pyelonephritis, and prostatitis.

McGraw-Hill Education, New York Freire MP, Martinho L, Mendes CV, Spadão F, De Paula FJ, Nahas WC, David-Neto E, Pierrotti LC Institutional protocol adherence in the incidence of recurrent urinary tract infection after kidney transplantation.

Vet Clin North Am Small Anim Pract — Article PubMed PubMed Central Google Scholar Behzadi P Classical chaperone-usher CU adhesive fimbriome: uropathogenic Escherichia coli UPEC and urinary tract infections UTIs. Folia Microbiol Praha Matulay JT, Mlynarczyk CM, Cooper KL Urinary tract infections in women: pathogenesis, diagnosis, and management.

Curr Bladder Dysfunct Rep —60 Article Google Scholar Storme O, Tiran Saucedo J, Garcia-Mora A, Dehesa-Davila M, Naber KG Risk factors and predisposing conditions for urinary tract infection. Ther Adv Urol Article PubMed PubMed Central Google Scholar Asadi Karam MR, Habibi M, Bouzari S Urinary tract infection: pathogenicity, antibiotic resistance and development of effective vaccines against uropathogenic Escherichia coli.

Mol Immunol —67 Article CAS PubMed Google Scholar Lane DR, Takhar SS Diagnosis and management of urinary tract infection and pyelonephritis. Emerg Med Clin North Am — Article PubMed Google Scholar Khameneh B, Iranshahy M, Vahdati-Mashhadian N, Sahebkar A, Fazly Bazzaz BS Non-antibiotic adjunctive therapy: a promising approach to fight tuberculosis.

Pharmacol Res Article CAS PubMed Google Scholar Khameneh B, Diab R, Ghazvini K, Fazly Bazzaz BS Breakthroughs in bacterial resistance mechanisms and the potential ways to combat them.

Microb Pathog —42 Article CAS PubMed Google Scholar Khameneh B, Iranshahy M, Soheili V, Fazly Bazzaz BS Review on plant antimicrobials: a mechanistic viewpoint.

Antimicrob Resist Infect Control Article PubMed PubMed Central Google Scholar Bazzaz BSF, Fakori M, Khameneh B, Hosseinzadeh H Effects of omeprazole and caffeine alone and in combination with gentamicin and ciprofloxacin against antibiotic resistant staphylococcus aureus and Escherichia coli strains.

J Pharmacopuncture —54 Article PubMed PubMed Central Google Scholar Fazly Bazzaz BS, Khameneh B, Zahedian Ostad MR, Hosseinzadeh H In vitro evaluation of antibacterial activity of verbascoside, lemon verbena extract and caffeine in combination with gentamicin against drug-resistant Staphylococcus aureus and Escherichia coli clinical isolates.

Avicenna J Phytomed — PubMed PubMed Central Google Scholar Fazly Bazzaz BS, Sarabandi S, Khameneh B, Hosseinzadeh H Effect of catechins, green tea extract and methylxanthines in combination with gentamicin against Staphylococcus aureus and Pseudomonas aeruginosa : combination therapy against resistant bacteria.

J Pharmacopuncture — Article PubMed PubMed Central Google Scholar Baker JH, Qiu J, Grine K Role of complementary and alternative therapies in infectious disease.

Prim Care Clin Off Pract — Article Google Scholar Mantzorou M, Giaginis C Cranberry consumption against urinary tract infections: clinical state-of-the-art and future perspectives. Curr Pharm Biotechnol — Article CAS PubMed Google Scholar Poulios E, Vasios GK, Psara E, Giaginis C Medicinal plants consumption against urinary tract infections: a narrative review of the current evidence.

Expert Rev Anti Infect Ther —10 CAS Google Scholar Loubet P, Ranfaing J, Dinh A, Dunyach-Remy C, Bernard L, Bruyère F, Lavigne J-P, Sotto A Alternative therapeutic options to antibiotics for the treatment of urinary tract infections.

Front Microbiol Article Google Scholar Farhadi F, Khameneh B, Iranshahi M, Iranshahy M Antibacterial activity of flavonoids and their structure-activity relationship: an update review.

Phytother Res —40 Article CAS PubMed Google Scholar Shaheen G, Akram M, Jabeen F, Ali Shah SM, Munir N, Daniyal M, Riaz M, Tahir IM, Ghauri AO, Sultana S, Zainab R, Khan M Therapeutic potential of medicinal plants for the management of urinary tract infection: a systematic review.

Clin Exp Pharmacol Physiol — Article CAS PubMed Google Scholar Yarnell E Botanical medicines for the urinary tract. World J Urol — Article PubMed Google Scholar Bag A, Bhattacharyya S, Chattopadhyay R Medicinal plants and urinary tract infections: an update.

Phcog Rev Google Scholar Marino A, Bellinghieri V, Nostro A, Miceli N, Taviano MF, Guvenc A, Bisignano G In vitro effect of branch extracts of Juniperus species from Turkey on Staphylococcus aureus biofilm.

FEMS Immunol Med Microbiol — Article CAS PubMed Google Scholar Schilcher H Juniper berry oil in diseases of the efferent urinary tract?

Med Monatsschr Pharm — CAS PubMed Google Scholar Pepeljnjak S, Kosalec I, Kalodera Z, Blazevic N Antimicrobial activity of juniper berry essential oil Juniperus communis L. Acta Pharm — CAS PubMed Google Scholar Howell AB, Foxman B Cranberry juice and adhesion of antibiotic-resistant uropathogens.

JAMA — Article PubMed Google Scholar Burger O, Ofek I, Tabak M, Weiss EI, Sharon N, Neeman I A high molecular mass constituent of cranberry juice inhibits Helicobacter pylori adhesion to human gastric mucus. FEMS Immunol Med Microbiol — Article CAS PubMed Google Scholar Di Martino P, Agniel R, David K, Templer C, Gaillard JL, Denys P, Botto H Reduction of Escherichia coli adherence to uroepithelial bladder cells after consumption of cranberry juice: a double-blind randomized placebo-controlled cross-over trial.

World J Urol —27 Article PubMed Google Scholar Tao Y, Pinzon-Arango PA, Howell AB, Camesano TA Oral consumption of cranberry juice cocktail inhibits molecular-scale adhesion of clinical uropathogenic Escherichia coli. J Med Food — Article CAS PubMed PubMed Central Google Scholar LaPlante KL, Sarkisian SA, Woodmansee S, Rowley DC, Seeram NP Effects of cranberry extracts on growth and biofilm production of Escherichia coli and Staphylococcus species.

Phytother Res — Article CAS PubMed Google Scholar Howell AB, Reed JD, Krueger CG, Winterbottom R, Cunningham DG, Leahy M A-type cranberry proanthocyanidins and uropathogenic bacterial anti-adhesion activity. Phytochemistry — Article CAS PubMed Google Scholar Raditic DM Complementary and integrative therapies for lower urinary tract diseases.

Vet Clin North Am Small Anim Pract — Article PubMed Google Scholar Dason S, Dason JT, Kapoor A Guidelines for the diagnosis and management of recurrent urinary tract infection in women.

Can Urol Assoc J — Article PubMed PubMed Central Google Scholar Davidson E, Zimmermann BF, Jungfer E, Chrubasik-Hausmann S Prevention of urinary tract infections with Vaccinium products. Phytother Res — Article PubMed Google Scholar Head KA Natural approaches to prevention and treatment of infections of the lower urinary tract.

Altern Med Rev — PubMed Google Scholar Mary Anne Roshni Amalaradjou, Venkitanarayanan K Natural approaches for controlling urinary tract infections. Int J Drug Dev Res — Google Scholar Geetha RV, Roy A, Lakshmi T In vitro evaluation of anti bacterial activity of leaf extract of Agathosma betulina on urinary tract pathogens.

Intl J Pharm Sci Rev Res —97 Google Scholar Rafsanjany N, Lechtenberg M, Petereit F, Hensel A Antiadhesion as a functional concept for protection against uropathogenic Escherichia coli : In vitro studies with traditionally used plants with antiadhesive activity against uropathogenic Escherichia coli.

J Ethnopharmacol — Article PubMed Google Scholar Williams G, Craig JC Prevention of recurrent urinary tract infection in children. Curr Opin Infect Dis —76 Article PubMed Google Scholar Mutters NT, Mampel A, Kropidlowski R, Biehler K, Günther F, Bălu I, Malek V, Frank U Treating urinary tract infections due to MDR E.

Fitoterapia — Article CAS PubMed Google Scholar Drew A Goldenseal. Curr Ther —48 Google Scholar Tims M, Batista C Effects of root isoquinoline alkaloids from Hydrastis canadensis on Fusarium oxysporum isolated from Hydrastis root tissue.

J Chem Ecol — Article CAS PubMed Google Scholar Genovese C, Davinelli S, Mangano K, Tempera G, Nicolosi D, Corsello S, Vergalito F, Tartaglia E, Scapagnini G, Di Marco R Effects of a new combination of plant extracts plus d-mannose for the management of uncomplicated recurrent urinary tract infections.

J Chemother — Article CAS PubMed Google Scholar Ceyhan N, Keskin D, Uǧur A Antimicrobial activities of different extracts of eight plant species from four different family against some pathogenic microorganisms.

J Food Agric Environ — CAS Google Scholar Das G, Patra JK, Baek KH Antibacterial properties of endophytic bacteria isolated from a fern species Equisetum arvense L.

Foodborne Pathog Dis —58 Article CAS PubMed Google Scholar Asgarpanah J, Roohi E Phytochemistry and pharmacological properties of Equisetum arvense L.

J Med Plants Res — CAS Google Scholar Radojevic ID, Stankovic MS, Stefanovic OD, Topuzovic MD, Comic LR, Ostojic AM Great horsetail Equisetum telmateia Ehrh.

EXCLI J —67 PubMed PubMed Central Google Scholar Chrubasik JE, Roufogalis BD, Wagner H, Chrubasik SA A comprehensive review on nettle effect and efficacy profiles, part I: Herba urticae. Phytomedicine — Article CAS PubMed Google Scholar Kukrić ZZ, Topalić-Trivunović LN, Kukavica BM, Matoš SB, Pavičić SS, Boroja MM, Savić AV Characterization of antioxidant and antimicrobial activities of nettle leaves Urtica dioica L.

Afr J Microbiol Res — Article Google Scholar Kreft S, Lunder M Herbal medicinal products for the treatment of the urogenital infection. Farm Vestn —95 Google Scholar Bahmani M, Saki K, Shahsavari S, Rafieian-Kopaei M, Sepahvand R, Adineh A Identification of medicinal plants effective in infectious diseases in Urmia, northwest of Iran.

Asian Pac J Trop Biomed — Article Google Scholar Shaaban MT, Ghozlan HA, El Maghraby MM Susceptibility of bacteria infecting urinary tract to some antibiotics and essential oils.

JAPS Google Scholar Kwiecińska-Piróg J, Skowron K, Bogiel T, Białucha A, Przekwas J, Gospodarek-Komkowska E Vitamin C in the presence of sub-Inhibitory concentration of aminoglycosides and fluoroquinolones alters Proteus mirabilis biofilm inhibitory rate.

Antibiotics Article PubMed Central CAS Google Scholar Monroy-Torres R, Medina-Jiménez AK Cranberry juice and other functional foods in urinary tract infections in women: a review of actual evidence and main challenges.

Arch Pediatric Infect Dis 6:e Google Scholar Ochoa-Brust GJ, Fernandez AR, Villanueva-Ruiz GJ, Velasco R, Trujillo-Hernandez B, Vasquez C Daily intake of mg ascorbic acid as urinary tract infection prophylactic agent during pregnancy.

Acta Obstet Gynecol Scand — Article CAS PubMed Google Scholar Manzoor MAP, Duwal SR, Mujeeburahiman M, Rekha PD Vitamin C inhibits crystallization of struvite from artificial urine in the presence of Pseudomonas aeruginosa. Int Braz J Urol — Article PubMed PubMed Central Google Scholar Montorsi F, Gandaglia G, Salonia A, Briganti A, Mirone V Effectiveness of a combination of cranberries, Lactobacillus rhamnosus , and vitamin C for the management of recurrent urinary tract infections in women: results of a pilot study.

See All. DailyOM Courses. About DailyOM Most Popular Courses New Releases Trending Courses See All. Bioflavonoids Rutin. Brand Names: Amino-Opti-C , Limbrel , Pan C , Peridin-C , Rutin , Span C uses What is Bioflavonoids Rutin used for?

warnings What is the most important information I should know about Bioflavonoids Rutin? Ask a doctor, pharmacist, or other healthcare provider if it is safe for you to use this product if you have ever had: a stomach ulcer; liver disease; or any chronic medical condition. Side Effects.

Side Effects What are the side effects of Bioflavonoids Rutin? Common side effects may include: blurred vision; fast or slow heart rate; headache, pounding in your ears; dizziness, nervousness; skin redness or itching; or swelling, pain, or a heavy feeling in your legs or feet.

Less serious side effects may be more likely, and you may have none at all. Interactions What drugs and food should I avoid while taking Bioflavonoids Rutin?

Avoid using different forms of bioflavonoids pills, liquids, and others at the same time. Store bioflavonoids at room temperature away from moisture and heat.

What should I do if I missed a dose of Bioflavonoids Rutin? Details To add the following enhancements to your purchase, choose a different seller. Ships from.

Sold by. Vitamins To Go. This item is non-returnable This item is non-returnable. This item is non-returnable, but if the item arrives damaged or defective, you may request a refund or replacement.

Read full return policy. This item is non-returnable. Secure transaction Your transaction is secure. We work hard to protect your security and privacy.

Our payment security system encrypts your information during transmission. Learn more. Secure transaction. Customer Service. Add a gift receipt for easy returns. Add to List. Added to. Unable to add item to List.

Please try again. Sorry, there was a problem. There was an error retrieving your Wish Lists. List unavailable. Other Sellers on Amazon. Not added. Sold by: Highland Health Foods.

Sold by: DNS Health Foods. Sold by: WooHoo Natural. Image Unavailable Image not available for Color:. VIDEOS ° VIEW IMAGES. Now Foods Citrus Bioflavonoids - Capsules.

Brand: NOW. Search this page. Purchase options and add-ons. Brand Now Foods Item Form Capsule Primary Supplement Type Citrus Bioflavonoid Complex Diet Type Kosher Flavor Citrus. About this item Citrus Bioflavonoids are powerful polyphenolic compounds found in lemons, limes, oranges, grapefruits, and tangerines NOW Foods With ascorbic acid and Rutin Supports the immune system.

Report an issue with this product or seller. Frequently bought together. This item: Now Foods Citrus Bioflavonoids - Capsules. Get it as soon as Monday, Feb Get it as soon as Tuesday, Feb Total price:.

To see our price, add these items to your cart. Try again! Added to Cart. Add all 3 to Cart. Some of these items ship sooner than the others. Show details Hide details. Choose items to buy together. Similar items that may ship from close to you. Page 1 of 1 Start over Page 1 of 1.

Previous page. Amazon's Choice. Citrus Bioflavonoids Supplement mg Caplets Vegetarian, Non-GMO, and Gluten Free Formula Value Size by Horbaach. BlueBonnet Citrus Bioflavonoid Complex Milligram 90 VCap. Solgar Citrus Bioflavonoid Complex mg, Tablets - Antioxidant Support - Promotes Optimal Health - Non-GMO, Vegan, Gluten Free, Dairy Free, Kosher - Servings.

Get it Feb 12 - Only 13 left in stock - order soon. Now Foods Citrus Bioflavonoid, Count Pack of 1. Only 3 left in stock - order soon. Next page. NOW Foods Citrus Bioflavonoids -- Capsules. Compare with similar items This Item. Nature's Life Lemon Bioflavonoids mg - Citrus Bioflavonoids Supplement with Hesperidin and Rutin - Antioxidant and Cellular Support, Vitamin C Absorption - 60 Day Guarantee, Serv, Tablets.

KAL Bioflavonoid mg ct. Solgar — Citrus Bioflavonoid Complex, mg, Tablets. Healthway Shop. FortressBrand Wellness. Pattern Products. iHerb LLC.

Citrus Bioflavonoid Complex. Vitamin C. Vitamin C, Sodium.

The results of another study demonstrated that antibiotic therapy in combination with long-term enrichment of the diet with D-mannose leads to prolongation of the inter-relapse period of uncomplicated UTI [ 97 ].

The effects of different derivatives of the sugar in the control of UTIs were studied. Klein et al. synthesized and evaluated the efficacy of these sugars in blocking bacterial-host interaction. Among them, para-substituted biphenyl derivative was the most effective agent in controlling UTIs.

Following oral administration of this compound, bacterial numbers were reduced by twofold and fourfold in the urine and bladder, respectively [ ]. Probiotics are living microorganisms which when administered in certain numbers exert a health benefit on the host [ ].

The clinical efficacy of probiotics for adjunct treatment in the treatment of different gastrointestinal and urinary tract infections has been addressed previously [ ]. They have demonstrated positive effects in the treatment and prevention of rotavirus diarrhea and alleviation of the antibiotic-associated intestinal adverse effects by recognizing the commensal microbiota and also restoration of the microbial ecosystem after an imbalance or infection [ ].

Probiotics are clinically proven to be effective in the management of UTI including accelerating recovery after UTI and also decreasing recurrent UTI in children [ ]. These positive effects of probiotics might be attributed to the intrinsic properties of microorganisms.

Besides these advantages, probiotics could produce biosurfactants that inhibit the growth of uropathogens by reducing the adhesion of the pathogens to the uroepithelium.

Moreover, lactobacilli could co-aggregate with uropathogens and block their adhesion to the urinary tract and also displace previously adherent uropathogens from uroepithelium. This process can create a microenvironment in which the inhibitory products of lactobacilli can concentrate on the pathogens and therefore inhibit the pathogens [ ].

It is worth noting that the most effective lactobacilli for controlling UTI are L. rhamnosus GR-1 and L. reuteri B and RC which have been proven [ ]. The common vaginal Lactobacillus species were used to investigate the inhibition of E. coli growth. The results showed that when L. crispatus was incubated with clinical E.

coli strains, the growth of E. coli was inhibited in the acidic environment [ ]. Wolff et al. The physicochemical cell surface, adhesion properties, and the antagonistic activity of recombinant Lactococcus lactis containing the Ama r 2 gene against the E.

coli causing UTI in humans were studied. The results indicated that this recombinant probiotic showed desirable properties and the Ama r 2 gene expression did not affect the positive probiotic properties [ ].

The ability of a clinically isolated probiotic, L. fermentum strain 4—17, to adhere to human intestinal was studied. fermentum strain 4—17 showed appropriate anti-adhesive properties against human pathogenic bacteria [ ].

Osset et al. Among them, L. crispatus could block pathogen adhesion efficiently. The results of another study revealed that a pyelonephritic E. coli was sensitive to L. rhamnosus , Bifidobacterium lactis, and Bifidobacterium longus and these probiotics were able to suppress the growth of enteric and urinary pathogens [ ].

Oral administration of multispecies probiotic formulations showed antimicrobial activities against the pathogens that are responsible for vaginal dysbiosis and infections [ ]. The effects of vaginal suppositories of probiotics for the prevention and treatment of UTI have been studied previously.

The Lactobacillus strains inhibited the growth of E. coli via the production of organic acids. Additionally, the adhesion and internalization of E. coli into HeLa cells were reduced by probiotics [ ]. Reid et al. investigated the effect of probiotic lactobacilli in controlling acute UTI in women.

Based on the results, recurrence reduced remarkably in the Lactobacillus group compared to the placebo group [ ]. Taken together, the results of these aforementioned studies demonstrated the potential benefit of probiotics in controlling UTI.

Additionally, site-oriented probiotic therapy has been recognized as one of the most promising therapeutic alternatives for the prevention of UTI in post-antibiotic therapy [ ].

While most clinical research showed using these natural substances represents a promising approach, further studies are needed to prove their mechanism of action and clinical effectiveness.

It should be noted that formulating these substances in a single dosage form and their side effects and interactions with each other are the main limitations of developing a new formulation. Treatment with non-antibiotic agents is a good approach to reduce the risk of incidence of UTI and also decrease the symptoms of the illness.

Among these agents, natural substances, nutrients, and probiotics attract attention. Each of these agents acts by a different mechanism, and therefore, co-formulation of them in a single dosage form maybe provides the natural formulation that is effective for both preventive and therapeutic approaches in the management of UTI.

This review was based on data extracted from published papers available in all relevant databases without limitation up to October 1, Sheerin NS, Glover EK Urinary tract infection.

Medicine — Article Google Scholar. Sheerin NS Urinary tract infection. Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J Urinary tract infections, pyelonephritis, and prostatitis.

In: Harrison's principles of internal medicine, 20th edn. McGraw-Hill Education, New York. Freire MP, Martinho L, Mendes CV, Spadão F, De Paula FJ, Nahas WC, David-Neto E, Pierrotti LC Institutional protocol adherence in the incidence of recurrent urinary tract infection after kidney transplantation.

J Glob Antimicrob Resist — Article PubMed Google Scholar. Vet Clin North Am Small Anim Pract — Article PubMed PubMed Central Google Scholar. Behzadi P Classical chaperone-usher CU adhesive fimbriome: uropathogenic Escherichia coli UPEC and urinary tract infections UTIs. Folia Microbiol Praha.

Matulay JT, Mlynarczyk CM, Cooper KL Urinary tract infections in women: pathogenesis, diagnosis, and management. Curr Bladder Dysfunct Rep — Storme O, Tiran Saucedo J, Garcia-Mora A, Dehesa-Davila M, Naber KG Risk factors and predisposing conditions for urinary tract infection.

Ther Adv Urol Asadi Karam MR, Habibi M, Bouzari S Urinary tract infection: pathogenicity, antibiotic resistance and development of effective vaccines against uropathogenic Escherichia coli.

Mol Immunol — Article CAS PubMed Google Scholar. Lane DR, Takhar SS Diagnosis and management of urinary tract infection and pyelonephritis. Emerg Med Clin North Am — Khameneh B, Iranshahy M, Vahdati-Mashhadian N, Sahebkar A, Fazly Bazzaz BS Non-antibiotic adjunctive therapy: a promising approach to fight tuberculosis.

Pharmacol Res Khameneh B, Diab R, Ghazvini K, Fazly Bazzaz BS Breakthroughs in bacterial resistance mechanisms and the potential ways to combat them. Microb Pathog — Khameneh B, Iranshahy M, Soheili V, Fazly Bazzaz BS Review on plant antimicrobials: a mechanistic viewpoint.

Antimicrob Resist Infect Control Bazzaz BSF, Fakori M, Khameneh B, Hosseinzadeh H Effects of omeprazole and caffeine alone and in combination with gentamicin and ciprofloxacin against antibiotic resistant staphylococcus aureus and Escherichia coli strains.

J Pharmacopuncture — Fazly Bazzaz BS, Khameneh B, Zahedian Ostad MR, Hosseinzadeh H In vitro evaluation of antibacterial activity of verbascoside, lemon verbena extract and caffeine in combination with gentamicin against drug-resistant Staphylococcus aureus and Escherichia coli clinical isolates.

Avicenna J Phytomed — PubMed PubMed Central Google Scholar. Fazly Bazzaz BS, Sarabandi S, Khameneh B, Hosseinzadeh H Effect of catechins, green tea extract and methylxanthines in combination with gentamicin against Staphylococcus aureus and Pseudomonas aeruginosa : combination therapy against resistant bacteria.

Baker JH, Qiu J, Grine K Role of complementary and alternative therapies in infectious disease. Prim Care Clin Off Pract — Mantzorou M, Giaginis C Cranberry consumption against urinary tract infections: clinical state-of-the-art and future perspectives. Curr Pharm Biotechnol — Poulios E, Vasios GK, Psara E, Giaginis C Medicinal plants consumption against urinary tract infections: a narrative review of the current evidence.

Expert Rev Anti Infect Ther — CAS Google Scholar. Loubet P, Ranfaing J, Dinh A, Dunyach-Remy C, Bernard L, Bruyère F, Lavigne J-P, Sotto A Alternative therapeutic options to antibiotics for the treatment of urinary tract infections.

Front Microbiol Farhadi F, Khameneh B, Iranshahi M, Iranshahy M Antibacterial activity of flavonoids and their structure-activity relationship: an update review. Phytother Res — Shaheen G, Akram M, Jabeen F, Ali Shah SM, Munir N, Daniyal M, Riaz M, Tahir IM, Ghauri AO, Sultana S, Zainab R, Khan M Therapeutic potential of medicinal plants for the management of urinary tract infection: a systematic review.

Clin Exp Pharmacol Physiol — Yarnell E Botanical medicines for the urinary tract. World J Urol — Bag A, Bhattacharyya S, Chattopadhyay R Medicinal plants and urinary tract infections: an update.

Phcog Rev Google Scholar. Marino A, Bellinghieri V, Nostro A, Miceli N, Taviano MF, Guvenc A, Bisignano G In vitro effect of branch extracts of Juniperus species from Turkey on Staphylococcus aureus biofilm.

FEMS Immunol Med Microbiol — Schilcher H Juniper berry oil in diseases of the efferent urinary tract? Med Monatsschr Pharm — CAS PubMed Google Scholar. Pepeljnjak S, Kosalec I, Kalodera Z, Blazevic N Antimicrobial activity of juniper berry essential oil Juniperus communis L.

Acta Pharm — Howell AB, Foxman B Cranberry juice and adhesion of antibiotic-resistant uropathogens. JAMA — Burger O, Ofek I, Tabak M, Weiss EI, Sharon N, Neeman I A high molecular mass constituent of cranberry juice inhibits Helicobacter pylori adhesion to human gastric mucus.

Di Martino P, Agniel R, David K, Templer C, Gaillard JL, Denys P, Botto H Reduction of Escherichia coli adherence to uroepithelial bladder cells after consumption of cranberry juice: a double-blind randomized placebo-controlled cross-over trial.

Tao Y, Pinzon-Arango PA, Howell AB, Camesano TA Oral consumption of cranberry juice cocktail inhibits molecular-scale adhesion of clinical uropathogenic Escherichia coli.

J Med Food — Article CAS PubMed PubMed Central Google Scholar. LaPlante KL, Sarkisian SA, Woodmansee S, Rowley DC, Seeram NP Effects of cranberry extracts on growth and biofilm production of Escherichia coli and Staphylococcus species.

Howell AB, Reed JD, Krueger CG, Winterbottom R, Cunningham DG, Leahy M A-type cranberry proanthocyanidins and uropathogenic bacterial anti-adhesion activity.

Phytochemistry — Raditic DM Complementary and integrative therapies for lower urinary tract diseases. Dason S, Dason JT, Kapoor A Guidelines for the diagnosis and management of recurrent urinary tract infection in women.

Can Urol Assoc J — Davidson E, Zimmermann BF, Jungfer E, Chrubasik-Hausmann S Prevention of urinary tract infections with Vaccinium products. Head KA Natural approaches to prevention and treatment of infections of the lower urinary tract. Altern Med Rev — PubMed Google Scholar.

Mary Anne Roshni Amalaradjou, Venkitanarayanan K Natural approaches for controlling urinary tract infections. In: Tenke P ed Urinary tract infections. InTech, New York, pp — Int J Drug Dev Res — Geetha RV, Roy A, Lakshmi T In vitro evaluation of anti bacterial activity of leaf extract of Agathosma betulina on urinary tract pathogens.

Intl J Pharm Sci Rev Res — Rafsanjany N, Lechtenberg M, Petereit F, Hensel A Antiadhesion as a functional concept for protection against uropathogenic Escherichia coli : In vitro studies with traditionally used plants with antiadhesive activity against uropathogenic Escherichia coli.

J Ethnopharmacol — Williams G, Craig JC Prevention of recurrent urinary tract infection in children. Curr Opin Infect Dis — Mutters NT, Mampel A, Kropidlowski R, Biehler K, Günther F, Bălu I, Malek V, Frank U Treating urinary tract infections due to MDR E. coli with Isothiocyanates—a phytotherapeutic alternative to antibiotics?

Fitoterapia — Tims M, Batista C Effects of root isoquinoline alkaloids from Hydrastis canadensis on Fusarium oxysporum isolated from Hydrastis root tissue. J Chem Ecol — Genovese C, Davinelli S, Mangano K, Tempera G, Nicolosi D, Corsello S, Vergalito F, Tartaglia E, Scapagnini G, Di Marco R Effects of a new combination of plant extracts plus d-mannose for the management of uncomplicated recurrent urinary tract infections.

J Chemother — Ceyhan N, Keskin D, Uǧur A Antimicrobial activities of different extracts of eight plant species from four different family against some pathogenic microorganisms.

J Food Agric Environ — Das G, Patra JK, Baek KH Antibacterial properties of endophytic bacteria isolated from a fern species Equisetum arvense L. against foodborne pathogenic bacteria Staphylococcus aureus and Escherichia coli OH7. Foodborne Pathog Dis — Asgarpanah J, Roohi E Phytochemistry and pharmacological properties of Equisetum arvense L.

J Med Plants Res — Radojevic ID, Stankovic MS, Stefanovic OD, Topuzovic MD, Comic LR, Ostojic AM Great horsetail Equisetum telmateia Ehrh. EXCLI J — Chrubasik JE, Roufogalis BD, Wagner H, Chrubasik SA A comprehensive review on nettle effect and efficacy profiles, part I: Herba urticae.

Phytomedicine — Kukrić ZZ, Topalić-Trivunović LN, Kukavica BM, Matoš SB, Pavičić SS, Boroja MM, Savić AV Characterization of antioxidant and antimicrobial activities of nettle leaves Urtica dioica L.

Acta Periodica Technol — Balkhi TMB, Bhat FA Bioactive potential of leaf extracts from Urtica dioica L. against fish and human pathogenic bacteria.

Afr J Microbiol Res — Kreft S, Lunder M Herbal medicinal products for the treatment of the urogenital infection. Farm Vestn — Bahmani M, Saki K, Shahsavari S, Rafieian-Kopaei M, Sepahvand R, Adineh A Identification of medicinal plants effective in infectious diseases in Urmia, northwest of Iran.

Asian Pac J Trop Biomed — Shaaban MT, Ghozlan HA, El Maghraby MM Susceptibility of bacteria infecting urinary tract to some antibiotics and essential oils. JAPS Kwiecińska-Piróg J, Skowron K, Bogiel T, Białucha A, Przekwas J, Gospodarek-Komkowska E Vitamin C in the presence of sub-Inhibitory concentration of aminoglycosides and fluoroquinolones alters Proteus mirabilis biofilm inhibitory rate.

Antibiotics Article PubMed Central CAS Google Scholar. Monroy-Torres R, Medina-Jiménez AK Cranberry juice and other functional foods in urinary tract infections in women: a review of actual evidence and main challenges. Front Clin Drug Res Anti Infect. Yousefichaijan P, Goudarzi AA, Rezagholizamenjany M, Kahbazi M, Rafeie M, Shabestari AA, Shariatmadari F, Taherahmadi H Efficacy of ascorbic acid supplementation in relief of symptoms due to febrile upper urinary tract infection in children, a clinical trial and hospital based study.

Arch Pediatric Infect Dis 6:e Ochoa-Brust GJ, Fernandez AR, Villanueva-Ruiz GJ, Velasco R, Trujillo-Hernandez B, Vasquez C Daily intake of mg ascorbic acid as urinary tract infection prophylactic agent during pregnancy.

Acta Obstet Gynecol Scand — Manzoor MAP, Duwal SR, Mujeeburahiman M, Rekha PD Vitamin C inhibits crystallization of struvite from artificial urine in the presence of Pseudomonas aeruginosa. Int Braz J Urol — Montorsi F, Gandaglia G, Salonia A, Briganti A, Mirone V Effectiveness of a combination of cranberries, Lactobacillus rhamnosus , and vitamin C for the management of recurrent urinary tract infections in women: results of a pilot study.

Eur Urol — Carlsson S, Wiklund NP, Engstrand L, Weitzberg E, Lundberg JON Effects of pH, nitrite, and ascorbic acid on nonenzymatic nitric oxide generation and bacterial growth in urine. Nitric Oxide Biol Chem — Article CAS Google Scholar.

Yoo C, Kim CS Complementary and alternative medicine in urology. Korean J Urol — Yilmaz A, Bahat E, Yilmaz GG, Hasanoglu A, Akman S, Guven AG Adjuvant effect of vitamin A on recurrent lower urinary tract infections. Pediatr Int — Kahbazi M, Sharafkhah M, Yousefichaijan P, Taherahmadi H, Rafiei M, Kaviani P, Abaszadeh S, Massoudifar A, Mohammadbeigi A Vitamin A supplementation is effective for improving the clinical symptoms of urinary tract infections and reducing renal scarring in girls with acute pyelonephritis: a randomized, double-blind placebo-controlled, clinical trial study.

Complement Ther Med — Sobouti B, Hooman N, Movahed M The effect of vitamin e or vitamin A on the prevention of renal scarring in children with acute pyelonephritis. Pediatr Nephrol — Ayazi P, Moshiri SA, Mahyar A, Moradi M The effect of vitamin A on renal damage following acute pyelonephritis in children.

Eur J Pediatr — Smith JM, Cancienne JM, Brockmeier SF, Werner BC Vitamin D deficiency and total shoulder arthroplasty complications. Shoulder Elbow.

Hertting O, Lüthje P, Sullivan D, Aspenström P, Brauner A Vitamin D-deficient mice have more invasive urinary tract infection. PLoS ONE e Article PubMed PubMed Central CAS Google Scholar.

Ramos NL, Sekikubo M, Kironde F, Mirembe F, Sääf M, Brauner A The impact of vitamin D on the innate immune response to uropathogenic Escherichia coli during pregnancy.

Clin Microbiol Infect Deng QF, Chu H, Wen Z, Cao YS Vitamin D and urinary tract infection: a systematic review and meta-analysis. Ann Clin Lab Sci — Handoka NM, Amin RE, Shalaby SA Vitamin D deficiency is associated with urinary tract infection in children.

Arch Med Sci — Tekin M, Konca C, Celik V, Almis H, Kahramaner Z, Erdemir A, Gulyuz A, Uckardes F, Turgut M The association between Vitamin D levels and urinary tract infection in children.

Horm Res Paediatr — Haghdoost S, Pazandeh F, Darvish S, Khabazkhoob M, Huss R, Lak TB Association of serum vitamin D levels and urinary tract infection in pregnant women: a case control study.

Eur J Obstet Gynecol Reprod Biol — Georgieva V, Kamolvit W, Herthelius M, Lüthje P, Brauner A, Chromek M Association between vitamin D, antimicrobial peptides and urinary tract infection in infants and young children. Acta Paediatr Int J Paediatr — Jorde R, Sollid ST, Svartberg J, Joakimsen RM, Grimnes G, Hutchinson MYS Prevention of urinary tract infections with vitamin D supplementation 20, IU per week for five years.

Results from an RCT including subjects. Infect Dis — Hemila H, Chalker E The effectiveness of high dose zinc acetate lozenges on various common cold symptoms: a meta-analysis.

BMC Fam Pract Consolo LZZ, Melnikov P, Cônsolo FZ, Nascimento VA, Pontes JCDV Zinc supplementation in children and adolescents with acute leukemia. Eur J Clin Nutr — Haider BA, Lassi ZS, Ahmed A, Bhutta ZA Zinc supplementation as an adjunct to antibiotics in the treatment of pneumonia in children 2 to 59 months of age.

Cochrane Datab Syst Rev J Enzyme Inhib Med Chem — Dizdar OS, Baspınar O, Kocer D, Dursun ZB, Avcı D, Karakükcü C, Çelik I, Gundogan K Nutritional risk, micronutrient status and clinical outcomes: a prospective observational study in an infectious disease clinic.

Nutrients Hamer DH, Sempértegui F, Estrella B, Tucker KL, Rodríguez A, Egas J, Dallal GE, Selhub J, Griffiths JK, Meydani SN Micronutrient deficiencies are associated with impaired immune response and higher burden of respiratory infections in elderly Ecuadorians.

J Nutr — Mohsenpour B, Ahmadi A, Baneh AM, Hajibagheri K, Ghaderi E, Afrasiabian S, Azizi S Relation between serum zinc levels and recurrent urinary tract infections in female patients: a case—control study.

Med J Islam Repub Iran — Tehran Uni Med J — Narayanan A, Nair MS, Muyyarikkandy MS, Amalaradjou MA Inhibition and inactivation of uropathogenic Escherichia coli Biofilms on urinary catheters by Sodium Selenite. Int J Mol Sci Deutch CE, Spahija I, Wagner CE Susceptibility of Escherichia coli to the toxic L-proline analogue L-selenaproline is dependent on two L-cystine transport systems.

J Appl Microbiol — Hafez AS, Fahim HI, Wafaay H, Mohamed FA A comparative study of blood retinol and selenium in minor lower urinary lesions.

A case control study. J Egypt Public Health Assoc — Hyre AN, Kavanagh K, Kock ND, Donati GL, Subashchandrabose S Copper is a host effector mobilized to urine during urinary tract infection to impair bacterial colonization.

Infect Immun Subashchandrabose S, Mobley HLT Back to the metal age: battle for metals at the host-pathogen interface during urinary tract infection.

Metallomics — Subashchandrabose S, Hazen TH, Brumbaugh AR, Himpsl SD, Smith SN, Ernst RD, Rasko DA, Mobley HLT Host-specific induction of Escherichia coli fitness genes during human urinary tract infection.

Proc Natl Acad Sci USA — Natural Factors Citrus Bioflavonoids 90 caps Price Was. Current Stock:. Natural Factors Citrus Bioflavonoids Plus Hesperidin mg Capsules Bioflavonoids are a group of plant pigments that are largely responsible for colours of many fruits and vegetables, and include a large number of nutrients with antioxidant activity.

They are sometimes referred to as vitamin P because they have vitamin-like properties. Citrus bioflavonoids are derived from the rind and pulp of citrus fruits. Citrus bioflavonoids work synergistically with vitamin C as they are needed for vitamin C to be used effectively by the body.

Uncropped scans of the blots were shown in Supplementary Fig. To analyze the localization of EGFP-fused URAT1 protein, fluorescence was observed using the FV10i Confocal Laser Scanning Microscope Olympus, Tokyo, Japan.

The [8- 14 C]-urate transport activity of URAT1, in the presence or absence of test compounds at the indicated concentrations with 0. We then measured the radioactivity in the lysate using a liquid scintillator Tri-Carb TR, PerkinElmer, Waltham, MA, USA.

The protein concentrations were determined using the Pierce TM BCA Protein Assay Kit. URAT1-dependent urate transport activity was calculated by subtracting the urate transport activity of mock cells from that of the URAT1-expressing cells.

To address IC 50 values of each test compound against the urate transport by URAT1, the urate transport activities were measured in the presence of test compounds at several concentrations. Based on the calculated values, fitting curves were obtained according to the following formula 1 using the least-squares methods with the Excel Microsoft, Redmond, WA, USA :.

where, E max is the maximum effect, EC 50 is the half maximal effective concentration, C is the concentration of the test compound, and n is the sigmoid-fit factor. Finally, based on the results, the IC 50 was calculated.

All statistical analyses were performed using Excel Microsoft with Statcel3 add-in software OMS publishing, Saitama, Japan. Different statistical tests were used for different experiments as described in the figure legends. Each experiment was designed to use the minimum number of samples required to obtain informative results and sufficient material for subsequent studies.

No specific statistical test was used to pre-determine the sample sizes empirically determined in the current study. All experiments were monitored in a non-blinded fashion. Samples that had undergone technical failure during processing were excluded from analyses. Dalbeth, N.

Lancet , — Article CAS Google Scholar. Miyata, H. et al. Identification of febuxostat as a new strong ABCG2 inhibitor: potential applications and risks in clinical situations. Article Google Scholar. Dua, P. Liu, K. Chemical evidence for potent xanthine oxidase inhibitory activity of ethyl acetate extract of Citrus aurantium L.

dried immature fruits. Molecules 21 , Enomoto, A. Molecular identification of a renal urate anion exchanger that regulates blood urate levels.

Nature , — Tan, P. Mechanism of high affinity inhibition of the human urate transporter URAT1. Yu, Z. Drug Metab. Mo, S. Hypouricemic action of selected flavonoids in mice: structure-activity relationships. Haidari, F.

Orange juice and hesperetin supplementation to hyperuricemic rats alter oxidative stress markers and xanthine oxidoreductase activity.

Barreca, D. Flavanones: citrus phytochemical with health-promoting properties. BioFactors 43 , — Escudero-Lopez, B. Consumption of orange fermented beverage improves antioxidant status and reduces peroxidation lipid and inflammatory markers in healthy humans.

Food Agric. Nagahama, N. Japanese Unexamined Patent Application Publication. Report No. JPA Japan Patent Office, Li, S. Identification of nobiletin metabolites in mouse urine. Food Res. Toyoda, Y. Functional characterization of clinically-relevant rare variants in ABCG2 identified in a gout and hyperuricemia cohort.

Cells 8 , Regulation of the axillary osmidrosis-associated ABCC11 protein stability by N-linked glycosylation: effect of glucose condition. PLoS ONE 11 , e