Editor’s note: This article is from 2017. Scroll to the end for a 2026 update on the UTI vaccine, which is now in real-world use in about 26 countries.
What’s new in UTI treatment research? Plenty, actually!
For ages physicians were treating urinary tract infections with antibiotics. A course of Macrobid or Kephlex is still a “go to” strategy to fight a UTI, one of the most common infections in the world. Some antibiotics enjoy better results than others, but all disrupt human flora and contribute to antibiotic resistance.
Now, in the “post-antibiotic era”, UTI treatment research focuses on alternative solutions instead of creating yet another antibiotic.
UTI vaccines, mannosides, probiotics, anti-inflammatory drugs, and biofilm destroyers are emerging as the newest trends in UTI treatment research.
#1 UTI Vaccines
Efforts to develop a UTI vaccine have been ongoing among at least several labs for over than 10 years. However, these have met with variable levels of success in animal models.
On top of the problems with the research, pharmaceutical companies are not eager to invest in UTI prevention, they’d much rather “invest in pills taken daily to treat chronic conditions”. After all, UTI is the second commonest infection and it’s a big market.
So far, two different vaccines made headlines and attracted the attention of the medical research community, both were developed by a team from the University of Michigan Medical School. One of the vaccines affects how E. coli feeds itself (more specifically a vaccine against a molecule that the bacteria usually use to grab iron). Another vaccine is made of proteins from the bacteria. The combination of two approaches seems the most promising and fuels further research in labs across the world.
#2 Mannosides
Your physician might be soon prescribing a sugar pill to treat UTIs. Apparently, E. coli bacteria that causes 90% of all infections, has a “sweet tooth”. It latches on to the naturally produced sugar (mannose) in your bladder walls and that’s why it is almost impossible to get rid of it by simply drinking water. It sticks to the bladder walls and it’s impossible to wash it away!
However, if you introduce some free-floating mannose in the urine, the bacteria will grab on to it instead, let go of your bladder walls, and could be easily washed out with urine flow.
- Since 70th dozens of UTI treatment research papers were published on the interaction of E.coli with mannose.
- There are clinical studies that demonstrated the effectiveness of D-Mannose, the naturally occurring sugar.
- You can find thousands of anecdotes from patients praising natural D-Mannose for curing their recurring infections.
- In 2017 D-Mannose manufacturers appealed to FDA to reclassify it as a pharmaceutical (not a supplement).
- There are several laboratories working on creating an artificial mannoside that would bind to E. coli better (10 thousands times stronger than natural D-Mannose!)
- Glaxo Smith Klein (the world’s sixth largest pharmaceutical company as of 2015) invested in mannoside research in 2016.
The research groups project human trials for mannosides in 2018 and are hopeful to put the drug on the shelves of the pharmacies in the nearest future.
#3 Probiotics
Human microbiota has been receiving much attention recently, with probiotic supplements available and recommended for many human conditions. No wonder, since thousands of good bacteria living in and on our body are still mostly undiscovered. So far we happen to only find out the role of the microbiome balance once we break it.
Unfortunately, changes in human microbiome have a domino effect. If you affect flora in your gut, suddenly not only your digestive health is ruined, but your mental health, vaginal, bladder, skin, and other systems wellbeing can go astray. Consequently, when it comes to UTI treatment research, the role of good bacteria in vagina and bladder attracts more and more attention in the medical and research community.
How probiotics work
Most of the interaction between host microbiota and harmful bacteria is still unknown, but some theories mechanisms of natural defense are already emerging. Some researchers have reported the following beneficial roles of good bacteria:
- Decrease inflammatory reaction of the bladder and help to restore healthy lining
- Some believe that Lactobacillus produce hydrogen peroxide, which protects bladder against E. coli.
- Some proposed thatLactobacillus help to produce collagen and prevent E. coli from binding with bladder lining.
- Lactobacillus species and Bifidobacteria species help to modulate immune responses.
Regardless of how the good microbes work, studies have revealed that decreased bacterial diversity is a significant risk factor for developing a UTI. Lactobacillus species seem to have the most promise and are already well researched. “Lactobacillus probiotics, taken either orally or vaginally, are likely effective in reducing recurrent urinary tract infections in women. Although more research is needed, probiotics should be considered a useful and safe alternative to antibiotics.”
Maybe it is the time for probiotics to undo all the harm that years of unnecessary use of antimicrobials have caused? Read how to choose the right probiotics.
#4 Anti-inflammatory drugs
In 2014 researchers from Washington University School of Medicine in St. Louis, MO, shared their findings at the annual meeting of the American Society for Microbiology. Apparently, When you get a UTI, immune cells, called neutrophils, attack the bacteria but also damage bladder lining.
Once the protective bladder lining is damaged, it is easier for the offending bacteria to hide and multiply again once the antibiotic attack is over. “By manipulating the strength of the neutrophil response in mice, so it was not too little or too much, the researchers were able to wipe out UTIs without increasing the risk of future infection”.
This discovery leads to a series of clinical studies focused on UTI treatment with Ibuprofen. According to some trials, 300 mg of ibuprofen daily worked as well as Cipro!
After analyzing the results of the trial, researchers went as far as suggesting that treatment recommendations for uncomplicated UTI should be changed. They recommended choosing anti-inflammatory agents as the first choice therapy for uncomplicated UTI, and antibiotic treatment only for those patients who return with persisting or recurrent symptoms.
Results of other studies also support the assumption of non-inferiority of ibuprofen compared to antibiotics for treatment of symptomatic uncomplicated UTI.
It’s important to note, that this treatment option also results in a higher risk of developing kidney infection and is not recommended for patients with a history of heart problems.
#5 Bacterial biofilms
When your healthy bladder is attacked by pathogenic bacteria, your body deploys multiple natural defense agents to protect you from the invasive bacteria. However, it has been discovered that E. coli forms Intracellular bacterial biofilm-like pods that allow it to “hide” from your natural defenses and from antibiotic treatment.
Biofilms are microbial communities consisting of bacteria, extremely capable to self-reproduce and resistance to antibiotics and natural defense mechanism. Many problems of treating chronic UTI with antibiotics stem from the inability of antibiotics and the human body’s defenses to penetrate and destroy biofilms.
However, in recent years clinical studies that combined antibiotics and biofilm targeting molecules (such as N-acetylcysteine marketed as NAC on Amazon) demonstrated most promising results in breaking down up to 99% of bacterial biofilms.
Naturopathic doctors are already using NAC to improve their patients’ chances to recover from chronic UTIs. Hopefully, these UTI treatment research results will eventually make its way into the mainstream healthcare.
Stay healthy and let me know if there is anything else you have heard of, that I did not cover in this post!
Update — October 2026
When I wrote this in 2017, a UTI vaccine was still mostly animal-model research. That has changed.
The furthest-along option is MV140 (brand name Uromune) — a sublingual spray taken under the tongue daily for about three months. It contains four inactivated (killed) bacteria behind most UTIs — E. coli, Klebsiella pneumoniae, Enterococcus faecalis, and Proteus vulgaris — and trains the immune defenses of the mucous membranes, where UTIs actually start, instead of using an injection.
What the research shows. A randomized controlled trial (NEJM Evidence, 2022) and multiple real-world studies have reported large drops in recurrence. A 2024 North American study found UTIs fell about 76% compared with the year before, and UK data showed roughly 78% of women were UTI-free at 12 months, with some long-term follow-up suggesting protection lasting years from a single three-month course.
Where you can get it. MV140 has been in clinical use in Spain since 2010 and is now available in about 26 countries, including Spain, the UK, Portugal, Mexico, and Australia.
In the United States, it is not FDA-approved. It can currently be accessed only through special-access programs, and a full U.S. approval is likely still years away.
One honest caveat: much of the evidence so far is real-world and observational rather than large U.S. placebo-controlled trials, so the effect may look more modest under stricter testing.
Sources: NEJM Evidence, 2022 (randomized trial); North American clinical study, 2024.
What happened to the vaccines in the original article? The two University of Michigan candidates described above — the siderophore (“iron-grabbing”) vaccine and the protein-based vaccine — are still preclinical. They have protected mice, and work best when combined, but have not yet entered human trials. Meanwhile the most advanced injectable E. coli vaccine, ExPEC9V (Sanofi / Johnson & Johnson), reached a large Phase 3 trial — but it was stopped in February 2025 after it did not show sufficient efficacy. For now, the approach that has actually reached patients is the sublingual one (MV140), not the injectables.
More sources: University of Michigan siderophore vaccine (2016); Sanofi ExPEC9V Phase 3 update, Feb 2025; CIDRAP coverage.
