Natural Approaches for Controlling Urinary Tract Infections

Urinary Tract Infections (UTIs) account for nearly 8 million physician visits and 1.5 million visits to emergency rooms annually in the United States (Foxman, 2003; Litwin et al., 2005; Stamm and Hooton, 1993). It is the second most common infection of any organ and is one of the most common infections in humans (Tabiban et al., 2008). UTIs account for a total annual cost of more than $ 3.5 billion in the United States (Litwin et al., 2005). UTI refers to the presence of clinical signs and symptoms arising from the genitourinary tract associated with the presence of one or more microorganisms (Guay, 2009). UTIs are usually localized to the bladder, kidneys or prostate. The term UTI in this chapter refers to infections of the lower urinary tract that involve the bladder and urethra. Escherichia coli is the predominant uropathogen responsible for roughly 80% of all UTI cases, followed by Staphylococcus, Klebsiella, Enterobacter, Proteus and Enterococci species (Ronald, 2003). There are several approaches to the treatment and management of UTIs. Accurate classification of cases is the foremost and critical step in the clinical management of UTIs. UTIs may be primarily distinguished between the two anatomic locations of the infection, namely upper and lower tract infections. In majority of cases, the infection is associated with the lower part of the tract (Najar et al., 2009). Additionally, the infection may also be classified as complicated and uncomplicated based on the level of tissue involvement. Uncomplicated infections engross an episode of cysto-urethritis associated with bacterial colonization of the ureteral and bladder mucosa. Complicated infections involve pyelonephritis or prostitis and often occur as a result of obstruction or instrumentation in the tract (Huland and Busch, 1984; Najar et al., 2009). UTIs may also be classified as recurrent infection, reinfection or relapse (Najar et al., 2009). Reinfection is recurring infection due to a different microorganism that is usually drug susceptible, whereas relapse is a return of infection due to the same microorganism which is drug resistant. A relapse implies that there has been a failure to eradicate the infection (Cattell, 1973). Traditionally, the treatment of UTIs consists of antimicrobial therapy administered in a regimen appropriate to the clinical situation, freqently administered temporally either as a prophylactic to reduce the risk of UTI or as a therapeutic approach. Several antibiotics such as penicillins, sulfanilamide, nitrofurantoin and cephalexin have been used in therapy (Nicolle, 2002). The customary UTI treatment involves a short course of antimicrobials such as a 3-day regimen of trimethorpim-sulfamethoxazole combination (Nickel, 2005a). This