Comparative analysis of the effectiveness of antibiotic therapy and combined administration of antibiotics, lactobacilli, and proanthocyanidins for asymptomatic bacteriuria in young pregnant women: A randomized prospective study

Abstract

Background. Asymptomatic bacteriuria in pregnant women is not accompanied by visible symptoms; however, it involves the risk of serious complications, including gestational pyelonephritis and/or preterm labor, thereby threatening the health of both mother and child. This condition raises particular concern in light of the growing global problem of antibiotic resistance causing traditional therapies to be less effective or futile. Therefore, a study into alternative medicine approaches to asymptomatic bacteriuria in pregnant women appears highly relevant in terms of developing new solutions for managing this condition while minimizing maternal and child health risks and preventing the spread of antibiotic resistance.Objectives. To conduct a comparative analysis of the effectiveness of antibiotic therapy and combined administration of antibiotics, lactobacilli, and proanthocyanidins for asymptomatic bacteriuria in young pregnant women.Methods. 50 pregnant women aged 15 to 17 and diagnosed with asymptomatic bacteriuria participated in a randomized prospective study. Patients were randomly divided into two groups depending on the treatment. Group 1 received standard antibiotic therapy; group 2 received a combination of antibiotics with lactobacilli and proanthocyanidins. Treatment was carried out in the Republican Clinical Perinatal Center, the Republic of Bashkortostan. Patients were enrolled in the study from February 2021 to January 2022. The observation period included several stages: 10 days after treatment (first control), 30 days after treatment (second control), and 2 months after delivery (final control). The condition of the urinary tract was assessed depending on bacterial concentration, with the diagnosis of asymptomatic bacteriuria being made in case of a 105 CFE/mL (colony forming units of bacteria per milliliter of urine). The endpoint of the study was considered to be the cure of pregnant women from asymptomatic bacteriuria, which was determined by the absence of bacteria in the urine 10 days after the therapy, as well as a recurrence-free period for two months after delivery. Statistical data processing was carried out using Statistica 10.0 (StatSoft, USA) for Windows and Microsoft Excel (Microsoft, USA). A statistical level with p ≤ 0.05 was considered significant.Results. Treatment outcomes showed a significant reduction in bacteriuria and recurrent infection, especially in the group receiving the combined therapy. No bacteriuria was reported in 36 % of patients in group 1 and 76 % in group 2 (Yates’ chi-squared test, p = 0.011). The incidence of preterm labor appeared lower in the combined therapy group (4 % for group 2 and 12 % for group 1). Complications were recorded in 11 young pregnant women of group 1 (44 %) and in 3 women of group 2 (12 %). Statistical analysis indicated significant differences between the groups in terms of complication rate after treatment (Fisher’s exact test, p = 0.015).Conclusion. Combined therapy including antibiotics, lactobacilli, and proanthocyanidins demonstrates high effectiveness as an alternative to conventional treatments of asymptomatic bacteriuria in pregnant women. Due to this approach, bacteriuria as well as recurrence rate decreases, thereby contributing to a more stable health status.

Keywords

• asymptomatic bacteriuria
• pregnancy
• antibiotic resistance
• lactobacilli
• proanthocyanidins