Lactobacillus Reuteri for Treatment of Uncomplicated UTI in Pregnant Women

Randomized controlled trial, aimed to evaluate the efficacy of Lactobacillus reuteri DSM 16666/ATCC 55845 & Lactobacillus reuteri DSM 17938 for the treatment of pregnant women with asymptomatic bacteriuria or uncomplicated acute cystitis. As primary outcome we will evaluate the number of cases with clinical (symptoms severity) or bacteriological cure in pregnant women with uncomplicated cystitis or asymptomatic bacteriuria after 7 days treatment with probiotics vs. placebo. As secondary outcome we will evaluate a) rate of recurrence cases in each group; b) time to relapse; c) frequency of pyelonephritis; d) birth weight and head circumference; d) number of cases of preterm babies (less than 36 weeks of gestation); e) frequency of antibiotic as rescue treatment; f) frequency of adverse related events in each arm and g) frequency of preeclampsia. Women on active group will receive a combination of at least 5*10^8 CFU of Lactobacillus reuteri DSM 16666/ATCC 55845 & Lactobacillus reuteri DSM 17938, PAC-A and Zinc. Women in control group will receive o Amoxicillin + clavulanic acid (500 mg twice daily) for seven days in patients with negative nitrites in dipstick or oral nitrofurantoin (200mg twice per day) ror patients with positive dipstick.

Inclusion criteria

• Healthy women on the second or third trimester of pregnancy with positive urine culture according to the operational definition with or without symptoms
• Age 18 to 40 years
• Verbal and Written Informed Consent for participation in the study

Exclusion criteria

• Pathologic pregnancy (different for UTI)
• No supplementation of probiotics 2 weeks before study start or during the study period.
• Antibiotic therapy within last 2 weeks before randomization
• Known allergies towards the ingredients of the experimental product
• Inability to comprehend the study protocol
• Systemic diseases
• Multiple pregnancy