What is the best way to treat recurrent bladder infections?


When I was in medical school more than 45 years ago, I learned that E. Coli, a common intestinal bacteria, causes recurrent urinary tract infections in women; and that women with these infections should be given 100 ampicillin pills and be told to take one pill four times a day for three days, whenever they had symptoms: burning on urination or unreasonable urgency or frequency. They were also told to take one ampicillin pill before making love.

Dr. Joe Palermo of Washington University in St. Louis has found out why some women get urinary tract infections over and over again, in spite of the best medical treatment available today (Science, July 2003). He shows that the treatment I have been prescribing for more than 40 years is correct. Dr. Palermo showed in studies on mice that bacteria that cause bladder infections gather into fort-like pods that keep out antibiotics. The E. coli bacteria burrow into the cells that form the interior of the bladder, which helps them escape not only antibiotics but also the bladder’s mechanism for keeping itself clean by shedding a thin layer of cells. Every so often these pods break open, releasing bacteria, causing inflammation and the symptoms of bladder infection.

The pods are similar, but not identical, to other communities of bacteria called biofilm which help protect bacteria that cause cavities in your teeth. This same effect that causes recurrent bladder infections, and recurrent cavities in teeth, may also be responsible for recurrent infections elsewhere in the body including children who suffer recurrent ear infections.

May 1, 2006