Abstract

We assessed the effects of Chinese herbs on the uncomplicated urinary tract infections (UTIs) in women caused by fluoroquinolone-resistant strains. A total of 56 pre-menopausal women with uncomplicated UTIs caused by fluoroquinolone-resistant strains were included. Urine cultures were carried out. All organisms were proved to be fluoroquinolone-resistant at baseline. The patients were orally administrated Chinese herbal concoction for ten days. Chinese herbal concoction eradicated the primary pathogen in 71.4% of the patients at the 1-week follow-up. Among the 20 patients who had bacteriologic failures in the Day 5 of treatment, 2 developed superinfection. Of the failures in the group, Proteus mirabilis, Staphylococcus epidermidis and Providencia rettgeri were implicated in 50.0%, 50.0% and 100.0% of the failures, respectively. The clinical outcomes were also good, with cure or improvement for more than 80% of all subjects. About 14% of the study subjects reported at least one potential adverse event. The adverse events most frequently reported were nausea and diarrhea. All patients tolerated the symptoms. The adverse reactions did not prevail after discontinuation of the medication. Chinese herbal therapy may be an acceptable alternative for the treatment of uncomplicated UTIs caused by fluoroquinolone-resistant uropathogens.

Location of trial:  ChangChun (participants were outpatients of The First Affiliated Hospital to University  of Chines Medicine

Treatment

As an alternative therapeutic method, the patients were orally administrated Chinese herbal concoction. The prescription was as follow: Tong Cao [Stachyurus himalaicus Hook.f.et Thoms] 20g, Hua Shi [Talcum] 15g, Chi Shao [Paeonia lactiflora Pall.] 15g, Hui Xiang [Foeniculum vulgare Mill.] 15g, Guan Gui [Cinnamomum cassia Presl] 15g, Li Zhihe [Litchi chinensis Sonn] 15g, Tian Kuizi [Semiaquilegia adoxoides (DC.) makino] 15g, Zihua Diding [Viola ycdoensis Mak.] 20g, Ju Mai [Dianthus superbus L.] 15g, Ma Chixian [Portulaca oleracea L] 50g, Pu Gongying [Herba taraxaci] 30g. The concoction was prepared by mixing the crude drugs in 800ml water, getting 200ml liquor after the drugs decocted in 800ml water (100°C for 30 minutes twice). After cooling, concoction was stored with temperature 18–24°C, humidity 55%–70%. The concoction was orally administrated by 200ml/day for ten days.

Medical Condition

The target in this trial was floroquniolone resistant uncomplicated urinary tract infection (UTI). In other words bacteria infections in the urinary tract that have become resistant to a brand of anti-biotics.  UTI symptoms include painful urination with burning sensation, frequent urge to urinate and sometime pain in supra pubic region.

UTI is more common in women between 20 and 40 years of age. Over the course of just four years Bacteria Drug resistance in patient cases where the prescription of  fluoroquinolone s has doubled to 16% of cases examined in a study.

Participants

56 women aged between 20 – 45 years old without any significant underlying disease. All patients were ambulatory pre-menopausal.

Outcomes Measured

1. absence of key symptoms
2. decrease in severity of symptoms from initial assessment
3. failure: symptoms got worse or there were complications
4. Adverse reactions: any adverse affects from using the chinese herbal concoction.

Results

Of the 56 patients in this study, causative organisms isolated from urine cultures before treatment were (with number of strains in parentheses): Escherichia coli (35), Pseudomonas aeruginosa (10), Klebsiella pneumoniae (5), Proteus mirabilis (2), Staphylococcus epidermidis (2), and one each forStaphylococcus aureus, Proteus morganii, Enterobacter aerogenes, and Providencia rettgeri. Two patients were infected with two organisms.

More About one Treatment

7.1% patients had nausea, 3.6% had diarrhea. 1 patient had a skin rash and one patient had constipation. 

All patients completed the trial.

Cochrane Quality 

Not official information, so here are my observations

This was not a randomised controlled study and so did not involved a control and treatment gropup. All patients were aware of the type treatment given to them

Comments

This type of study could  be repeated in a randomised study with fluoroquinolone or a patient specific anti-biotic prescription based on drug resistant bacteria present.

References

Fluoroquinolone-Resistant Uncomplicated Urinary Tract Infections, Chinese Herbal Medicine May Provide Help Y Tong, Y Jing, D Zhao, L Zhang, S Zeng. African Journal of Traditional, Complementary and Alternative Medicines.