Recurrent urinary tract infections in adolescents

Urinary tract infections (UTIs) are a significant public health problem, as they are highly prevalent in both children and adults. By age 16, 11.3% of girls and 3.6% of boys will experience a UTI, and by age 24, one in three women will experience a UTI, with 50% of women experiencing a recurrence within the following year. Risk factors in children include structural and functional abnormalities with impaired urodynamics, urogenital malformations, crystalluria and urolithiasis, congenital tubulopathies, as well as foreign bodies in the urinary tract and promiscuity. Frequent recurrence of UTIs not only reduces quality of life but also requires the use of antimicrobials. This approach, endorsed by most international clinical guidelines, leads to an increased rate of progression of antibiotic resistance and, unfortunately, is not always sufficiently effective. This article presents several interesting clinical cases of UTIs in adolescents and highlights the problem of treating recurrent UTIs through the use of cranberry, D-mannose, and probiotics. A review of literature from domestic and international databases and electronic libraries was presented. A total of 58 articles were selected, including the necessary data from randomized controlled trials (RCTs), clinical guidelines, and case reports. According to the literature, cranberries are rich in complex phytochemicals that can exert anti-adhesive and antimicrobial effects, and probiotic use is a pathogenetically substantiated method for UTI prevention, as this disease is based on epithelial permeability syndrome and bacterial translocation. According to the literature, several studies have demonstrated anti-adhesive properties against E. coli with synthetic mannosides. A review of the literature suggests the potential for new approaches to UTI therapy; however, characterization of the underlying molecular mechanisms by which the antibacterial effect is mediated is required.

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