疫苗
若干随机对照试验对 OM-89 (Uro-Vaxom®) 进行了研究,发现它可降低尿路感染 (urinary tract infection, UTI) 的复发率。[52]Beerepoot MA, Geerlings SE, van Haarst EP, et al. Nonantibiotic prophylaxis for recurrent urinary tract infections: a systematic review and meta-analysis of randomized controlled trials. J Urol. 2013 Dec;190(6):1981-9.http://www.ncbi.nlm.nih.gov/pubmed/23867306?tool=bestpractice.com 口服疫苗含有 18 种大肠杆菌菌株的灭活提取物。此类免疫预防的安全性已得到充分证实,并在许多欧洲国家/地区获得了许可。Solco-Urovac® 是一种阴道栓剂,也含有大肠杆菌提取物,一些小型研究表明,它可以推迟复发性尿路感染女性的尿路感染复发时间。[52]Beerepoot MA, Geerlings SE, van Haarst EP, et al. Nonantibiotic prophylaxis for recurrent urinary tract infections: a systematic review and meta-analysis of randomized controlled trials. J Urol. 2013 Dec;190(6):1981-9.http://www.ncbi.nlm.nih.gov/pubmed/23867306?tool=bestpractice.com[53]Kochiashvili D, Khuskivadze A, Kochiashvili G, et al. Role of the bacterial vaccine Solco-Urovac® in treatment and prevention of recurrent urinary tract infections of bacterial origin. Georgian Med News. 2014 Jun;(231):11-6.http://www.ncbi.nlm.nih.gov/pubmed/25020163?tool=bestpractice.com 对于它在更多患者中的有效性,需要更有力的证据。
益生菌
通过 Meta 分析评估,使用乳杆菌属产品预防复发性尿路感染并未被证明有效。[54]Schwenger EM, Tejani AM, Loewen PS. Probiotics for preventing urinary tract infections in adults and children. Cochrane Database Syst Rev. 2015 Dec 23;(12):CD008772.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008772.pub2/abstracthttp://www.ncbi.nlm.nih.gov/pubmed/26695595?tool=bestpractice.com 然而,由于药品制剂的差异未考虑在内,因此需要进一步研究。
D-甘露糖
一项随机对照试验显示,D-甘露糖(一种单糖)在预防女性复发性尿路感染方面优于安慰剂,与呋喃妥因一样有效。[55]Kranjčec B, Papeš D, Altarac S. D-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial. World J Urol. 2014 Feb;32(1):79-84.http://www.ncbi.nlm.nih.gov/pubmed/23633128?tool=bestpractice.com 其他证据表明,它还有助于急性膀胱炎的紧急治疗。[56]Domenici L, Monti M, Bracchi C, et al. D-mannose: a promising support for acute urinary tract infections in women. A pilot study. Eur Rev Med Pharmacol Sci. 2016 Jul;20(13):2920-5.http://www.europeanreview.org/article/11121http://www.ncbi.nlm.nih.gov/pubmed/27424995?tool=bestpractice.com 推荐其用于治疗这两种适应症之前,还需要更有力的研究支持。
膀胱内灌注
使用膀胱内灌注替代膀胱糖胺聚糖层,是间质性膀胱炎的标准治疗方法。此疗法也被用以防止复发性 UTIs。一项综述强调,该疗法用于此适应症需提供更多证据。[57]Madersbacher H, van Ophoven A, van Kerrebroeck PE. GAG layer replenishment therapy for chronic forms of cystitis with intravesical glycosaminoglycans - a review. Neurourol Urodyn. 2013 Jan;32(1):9-18.http://www.ncbi.nlm.nih.gov/pubmed/22782909?tool=bestpractice.com