Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Lactobacillus crispatus is a species of probiotic bacteria naturally found in the healthy human vaginal and urogenital microbiota. Its use to support or treat urinary tract infections (UTIs) is scientifically justified to a moderate extent. Research demonstrates that L. crispatus plays a key role in maintaining a protective vaginal and periurethral environment, primarily by producing lactic acid and hydrogen peroxide, which inhibit the growth of uropathogens such as Escherichia coli—the most common cause of UTIs.

Clinical studies, including randomized controlled trials, have evaluated the effect of vaginal suppositories or oral capsules containing L. crispatus on recurrent UTIs in women. Notably, a 2011 study published in the New England Journal of Medicine (Stapleton et al.) found that women who received intravaginal L. crispatus had a significant reduction in recurrent UTI rates compared to placebo. The proposed mechanism is the restoration of a healthy lactobacilli-dominated vaginal microbiome, which serves as a barrier to pathogenic colonization.

However, while these findings are promising, the overall body of evidence is still limited by sample size, heterogeneity in probiotic formulations, and variable outcomes in different studies. Thus, the evidence rating is moderate (3 out of 5). L. crispatus is not a standard or first-line treatment for UTIs, but it is increasingly considered as a preventive adjunct, especially for women with recurrent infections who wish to avoid antibiotics.

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