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Treat and Prevent UTIs Without Drugs

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Reviewed by Phyllis J Gee, MD, FACOG

Urinary tract infections (UTIs), which are infections anywhere along the urinary tract, including the bladder and kidneys, are the second most common type of infection in the United States. (1) Read on for five ways to prevent and treat a UTI without antibiotics.

UTI treatment without antibiotics
It is possible to get rid of a UTI without antibiotics. iStock/Tom Merton

UTIs can be caused by poor hygiene, impaired immune function, the overuse of antibiotics, the use of spermicides, and sexual intercourse. The most common cause, accounting for about 90 percent of all cases, is the transfer of Escherichia coli bacteria from the intestinal tract to the urinary tract.

For those of you who have experienced a UTI, there isn’t much you wouldn’t do to avoid another one. While I personally have never had a UTI, my patients have told me how symptoms like pain, burning, nausea, and even bloody urine can be debilitating, and for those who get chronic UTIs, the fear of infection can be enough to prevent engagement in any activities that could trigger one. For people who get them frequently, sometimes a specific cause cannot even be pinpointed. This can be frustrating and scary.

Fortunately, there are a few methods of natural UTI treatment and prevention that have worked extremely well for my patients, to the point where they no longer worry about getting a UTI.

These treatments don’t require a prescription, are inexpensive, and are completely drug-free. While your doctor may not know about them, I hope this article will help you completely avoid UTIs—or at least significantly reduce their frequency and severity. I recommend working with a Functional Medicine practitioner who is focused on treating the root cause of your UTIs.

UTIs can be debilitating, but it is possible to get relief without requiring a prescription. Check out this article for five ways to cure UTIs without antibiotics. #functionalmedicine #wellness #chriskresser

What Is the Standard Treatment for a UTI?

Doctors typically use antibiotics to treat UTIs, and the type and duration depend on your health condition and the type of bacterium found in your urine. (2) Commonly prescribed antibiotics are:

  • Trimethoprim/sulfamethoxazole (Bactrim)
  • Amoxicillin
  • Ampicillin
  • Ciprofloxacin (Cipro)

These antibiotics are often unnecessary and may cause more problems in the future by destroying the beneficial bacteria that prevent pathogenic bacteria from growing. Long-term use of antibiotics can also lead to antibiotic resistance in strains of bacteria like E. coli in the gut, and a UTI caused by these bacteria will be even more challenging to eliminate and can cause more serious issues like a kidney or bladder infection.

Furthermore, antibiotics do very little to prevent the infection from happening in the first place. So, while drugs may be an easy fix for the short term, in the long run, you will continue to be susceptible to UTIs, and these infections may be worse than if you had never taken a course of antibiotics in the first place!

UTI treatment without antibiotics
Cranberries contain D-mannose, which is an effective natural remedy for UTIs. iStock/Terryfic3D

Curing and Preventing UTIs Naturally: D-Mannose

Treating UTIs with D-Mannose

D-mannose is by far the most effective supplement for both treatment and prevention of UTIs. Similar to glucose in structure, D-mannose is a naturally occurring sugar that is found in a number of fruits, including apples, blueberries, and cranberries. (3) This sugar is the reason that cranberry juice has been commonly recommended as a UTI treatment, though it is far easier to get the recommended dosage from a supplement. D-mannose is effective because it attaches to E. coli bacteria, causing them to stick to each other and preventing them from sticking to the walls of the urinary tract. (4) The bacteria can then easily be eliminated from the body during urination.

D-mannose, even in large quantities, does not cause any adverse effects, and cannot be metabolized the way other sugars can, meaning this supplement is safe for people with diabetes and others who are avoiding sugar for any reason. This treatment is also safe for children and the elderly.

Symptom relief can be seen as quickly as the following day, and most symptoms of UTI are generally resolved after 48 hours of treatment. Additionally, taking D-mannose during a time where you feel you are most prone to UTIs, such as before intercourse or during prolonged antibiotic treatment, can help prevent a UTI from ever developing in the first place. This is especially helpful for those who are prone to chronic UTIs and want to be able to engage in normal life activities without fear of infection.

The typical dose of D-mannose for UTI treatment is 500 mg, in capsule or powder form, taken with or in a glass of water or juice every two to three hours for five days. It is a good practice to continue taking the supplement even after symptoms have diminished to ensure complete elimination of the bacteria in the urinary tract. This dose can also be taken as a preventive, or prophylactic, method.

While there has not been any peer-reviewed research to support the effectiveness of D-mannose in treating or preventing UTIs, clinical and anecdotal experience suggests it is highly effective for the majority of infections, both acute and chronic. Some of my patients who have used D-mannose as a UTI treatment method have even described its effects as “miraculous”—so it’s definitely worth a shot!

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Four Alternative Treatments for Chronic UTIs

One caveat with D-mannose is that it is only effective with UTIs caused by E. coli infection. While this accounts for about 90 percent of cases, 10 percent will not benefit from this treatment. In this case, supplements that help disrupt biofilms can be useful in treating and preventing UTIs.

Biofilms are an accumulation of microorganisms and their extracellular products forming structured communities attached to a surface such as the lining of the urogenital tract. (5) The development of a biofilm can make infections extremely hard to treat, since they commonly return shortly after treatment is stopped.

The antibacterial resistance of pathogenic biofilms is one of the major reasons why those who get a UTI are highly susceptible to getting more in the future—if the biofilm is not completely eliminated, the infection will eventually return at some point.

1. InterFase Plus and Biofilm Defense

This is why the use of biofilm disruptors can be helpful for preventing the recurrence of chronic UTIs. The biofilm disruptors that I recommend to my patients are InterFase Plus from Klaire Labs or Biofilm Defense from Kirkman. These contain specialized enzymes to disrupt the biofilm matrix embedding potential of pathogens, and dissolve the sugar and fibrin components of most pathogenic biofilms. By destroying the biofilms, the recurrence of UTIs despite proper hygiene can be reduced. (6)

2. Lauricidin

Lauricidin is another supplement that may help in treating UTIs, particularly those that are caused by types of bacteria other than E. coli. Lauricidin (a proprietary form of monolaurin) has antiviral, antifungal, and antibacterial activity, and is specific against pathogenic bacteria so it won’t disrupt beneficial bacteria in the gut. It is highly effective at combating gram-positive bacteria in the families of: (7)

  • Streptococcus
  • Staphylococcus
  • Corynebacterium
  • Listeria
  • Bacillus
  • Clostridium

It works by disturbing the integrity of the bacterial cell membrane, blocking replication and making it easier for the immune system to destroy the pathogen. Lauricidin is only helpful, however, for UTIs not caused by E. coli, which is gram-negative and has a different kind of outer cell membrane than gram-positive bacteria.

3. Nattokinase

Nattokinase is another enzyme that has been shown to dissolve biofilms. (8) Produced by the bacteria found in the fermented food natto, this enzyme is proteolytic and can help break down the fibrin proteins that maintain the structure of biofilms.

Because of its fibrin-breaking ability, it’s important that nattokinase supplements are not taken by people with bleeding disorders, or by people who are taking Coumadin (warfarin), aspirin, or any other drug that influences blood clotting, unless supervised by a physician.

4. Apolactoferrin

Apolactoferrin (or lactoferrin) is one more supplement that I recommend to my patients with recurrent UTIs. This multifunctional protein lactoferrin is a component of the immune system with antimicrobial activity, and is part of the innate defense, found mainly in secretions and mucosal surfaces. (9)

Lactoferrin has been shown to block pathogenic biofilm development by binding to iron and causing the bacteria to “wander” across surfaces instead of forming cell clusters and biofilms. (10, 11) One study found that the amount of E. coli bacteria in the kidneys and bladder of mice was significantly reduced 24 hours after oral lactoferrin treatment, compared to a control group. (12) More research is necessary to demonstrate the effectiveness of lactoferrin in treating UTIs, but I believe it is worth trying, especially if dealing with chronic UTIs.

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1,826 Comments

Join the conversation

  1. After a trip to Costa Rica six months ago, my rectal area has been real sore and I lost 20 pounds. Just figured out that by seeing a urologist that I have an “Entercoccus Bacterial Infection in my Prostate”. Doc wants to put me on 4 weeks of CIPRO. Haven’t started it yet, Does anyone know of any natural products that can work to get rid of this? Thanks.

    • This is really serious. You are beyond natural remedies for what this is. You need the Cipro.
      ~Naturopath for 25 years.

      • I have taken Cipro. It is a broad spectrum antibiotic and very well tolerated. There are side effects with any drug including aspirin. It may be what is needed to eradicate your infection. I personally would not mess around with an infection contracted abroad.

  2. A couple of days ago I came down with a UTi first thing in the morning. Symptoms were great discomfort burning at end of peeing then feeling of burn and having to pee stayed with me. This also happened to me several years ago with the additional symptom of blood in urine. Simple solution both times worked. I drank a ton of water all day. Probably at least two gallons. In the evening I added Knudsen unsweetened cranberry juice to my water. It is not hard to drink if diluted to 4 parts water to one part cranberry juice. I probably only drank about 10 ounces of that. I ate only protein and good fat. Had spinach with lots of garlic. No sugar. I got up four times in the night to pee. By morning symptoms were gone. Oh and when I urinated, I bore down to increase flow of urine to flush out bacteria. I strongly believe that food is our medicine because after suffering from Crohn’s disease most of my life and going through many surgeries and then facing having my rectum removed and a permanent colostomy I went on the SCDiet and it all healed and have had no symptoms for 15 years now. Don’t forget to pray also. I always pray for wisdom on how to treat myself naturally. Hope this helps someone else. Katie

  3. I get uti’s all the time. Don’t know why. When I do I use one tablespoon apple cider vinegar (braggs), and 1/2 tsp baking soda mixed in 8oz warm water twice a day for 5 days. Works every time.

  4. are the biofilm disruptors only good for UTIs not caused by E. Coli? Or are biofilms part of all bacterial UTIs?

  5. URO VAXOM has changed my life. I am on the third month of the pills and I have not had any infection since then. I was having infections every 2 weeks and antibiotics were not working. Highly recommended but not sold in the USA.

  6. Hi everyone, I am quite amazed at the lack of mention of garlic……
    I have used this simple but magical remedy to treat ear infections/tooth infections/sinus infections/awful impetigo and most recently UTI.

    Simply crush 2/3 cloves raw garlic into a glass, leave for ten mins to oxidize, cover with juice of one lemon, a few shakes of cayenne pepper (raw and organic is much better) then Knock it back and chase with water/juice if need be.

    Repeat this every 3 hours or so for a couple of weeks to ensure the infection is gone.

    Symptoms usually begin to diminish after one or two treatments.

    I have had 100% success with a variety of infections, I urge you to try it xx

    • Hi

      Have you actually dont this for a UTI.

      I have tried the garlic on its own for 2 days now, bt still no relief.

  7. I have a neurogenic bladder and self-cath 100% of the time. As such, I am more prone to UTI’s than most. D-mannose has been amazingly effective—I have been able to wipe out an infection using that alone. However, as noted in the article, it ONLY works on E.Coli, so you need to monitor your symptoms and seek medical help if it does not appear to be working after 48 hours or so

  8. I am a male that gets UTI’s 3-4 times per year. I can no longer take antibiotics since it causes C Diff which is a severe infection of the intestines causing severe diarrhea for months. It too is treated with antibiotics which I am treatment resistant to. I had to have a fecal transplant to solve the problem. That’s why I can’t ever take antibiotics again

    I’ve been taking 12,600 of cranberry concentrate 2x’s per day which has been preventing UTI’s for over a year.

    Now I have a severe UTI with burning pain and increased frequency. I read through a lot of the posts on here and am confused on what the best treatment are for UTI. I will try the D-manose since this was recommended the most.

    Can anyone tell me what the next step should be?

    • good quality probiotics are key for prevention and can also help with treatment. I have seen HMF Intensive by Genestra 1-2capsules everyday prevent chronic longstanding UTIs from recurring.

    • I haven’t tried what I’m about to recommend but through searching for a natural treatment I came across this info: have a look on earth clinic. I have now ordered corn silk and oregano oil as was mentioned a lot. Oregano oil is supposed to be really affective at fighting infection and I had read that before.
      I’ve also heard colloidal silver is really good. I bought a book on interstitial cystitis and the author recommended colloidal silver but so far it hasn’t seemed to work for me. I tried d mannose and that didn’t seem to work either. Good luck finding a treatment
      If you get chance look at c Norman shealy he has written a book on natural remedies

      • Kat, where can I get the Colloidal Silver from? Its for my UTI infection. Please do let me know. I really appreciate it. Thanks.

    • I’ve been sugar/gluten free for almost 2 years. I still get the infection. Now if they’re loving whole food sugars then what’s a person to do? Eat meat and cabbage?

    • Can you tell me about your fecal transplant and where you had it done. I have heard it is one of the best new ways to replace and get the good bacteria replaced in your intestines and get them to stick.

      • You can only receive it as a treatment for chronic CDiff infection. Which I don’t wish on anyone. I have had it 9 times and none of the antibiotics worked. Luckily the transplant is the only thing that saved my life. Symptoms from C Diff include non stop watery diarrhea up to 30-35 times per day for 6 months straight. That means you are up all the time going. Require IV’s at all times and are never comfortable with all of the cramping. You usually catch this infection from a hospital following a surgery, which is what happened to me. Too many antibiotics killed all the good bacteria in my system and the bad take over. Then the treatment is using antibiotics to try and kill the bad bacteria.

        The only treatment that truly works is taking stool from a health person and transplanting the good bacteria into your body so it can take over the bad bacteria. It has a 90 % success rate. I had my treatment at Ohio State University Hospital since they actually have a stool bank. Otherwise it costs $3500 to have a family member’s stool tested before it can be implanted into your system. Stool from the bank costs $300.

      • I had mine done at Ohio State University mainly because they have a stool bank. This saves almost $4000 worth of testing for a family member to have before their stool can be used for transplant. Instead insurance covered the $400 fee for the stool.

    • If you have a recurrence of c-dif, then turn to something called Restoraflor. It has been used in Europe for years because it has been 100% effective. I was able to get this to my mother in hospital following a stroke, and meds she was put on which brought on the diarrhea. Is also useful in all cases of diarrhea. Google it. You can get this from pharmacy in Canada without a prescription, Also available in the U.S.

    • Sorry to say but D Mannose does NOT work for a lot of people…I am 1 of them..and I know of a lot of others as well.

  9. Hi,
    Had three infections and was in the middle of Keflex for the third occurrence when I found this article and got some D-Mannose. After two rounds of Keflex and one of Macrobid, one week after finishing the last antibiotic, there it was again. So this time I took heavy doses of the d-Mannose and it worked! I’m continuing to take about 1500 mg. a day spaced out, and it’s been six weeks. Life is going back to normal, even had a glass of wine a few days ago without any pain resultant. I’ll take this stuff for the rest of my life if needed. Thanks Chris Kresser! Also, I would love to know if the biofilm disruptors can be used along with the d-Mannose. From the research published, it seems that the E Coli bacteria form biofilms as well, leading to recurrence of infection.

  10. This article is old and I was just doing research for a patient of mine and thought I’d add this. There have now been 2 studies comparing D-Mannose and antibiotics. The first compared it to Nitrofurantoin (Macrobid) as a daily prophylactic for preventing UTI and the other was comparing D-Mannose to Trimethoprim-Sulfa (Bactrim). The results are not in for the second study, but for the first study they are in. Basically D-Mannose was slightly better at preventing subsequent UTIs when compared to Nitrofurantoin.

    Based on this information I have been telling my patients about D-Mannose and am looking forward to getting feedback from them on how it worked. One in particular has been dealing with 7+ UTI’s per year and I’m very interested to see how this works with her.

    Here is the link for the abstract of the study. http://www.ncbi.nlm.nih.gov/pubmed/23633128

  11. I’m so grateful for this site, it’s given me hope to combat my recurrent UTI’s without having to depend on antibiotics.
    According to my Doctor, it’s E Coli bacteria. I get infections between one to two times a month currently. it’s never been this bad before, maybe once every 6 months or so.
    I use special PH friendly wash. drink lots of water, wipe correctly, all that jazz.
    I’ve now tried D-Mannose, no effect as well as Biofilm Defense,which I think is helping slightly, but not hugely by any means.
    According to my Doctor it’s not cystitis and I’ve had an ultrasound done, y bladder looks and acts correctly as far as they can see.
    I will now try Apolactoferrin, here’s hoping that helps. I’m also taking olive leaf extract and probiotics (including ones with Lactobacillus rhamnosus and reuteri).
    Any other advice would be amazing!

    • I have found that d monase along with the herb holy basil, echenicheca extract, and Oregon graperoot extract works for me. I have to use all four together. It can be difficult to find Oregon graperoot extract but it is worth tracking it down. It can be extremely valuable to your health

    • Have your doctor test you for Interstitial Cystitis. I had what I thought were bladder infections for years. Turned out I have IC. There are treatments for it now that can help with the pain. Good luck, I know it’s a tough journey.

      • I was checked for Internal Cystitis yeah, came back negative. Also had blood tests and an ultrasound done, all came back in good shape.

    • This sounds too simple but I read it somewhere and it has worked for me. Drinking some baking soda water gives instant relief and knocked also knocked it out.

    • Have you tried cutting out egg/chicken or even all dairy? Eggs seemed to be the problem for my little girl. Dairy flares it up a bit but eggs make it painful for her. I Googled chicken and uti’s and found some interesting reading. Worth trying

  12. I haven’t read all the comments but have read as many as I could. I didn’t see any mention of using saw palmetto. It is listed as a help for prostate and urinary health. I am a female with ulcers in my bladder (diagnosed under sedation over 15 years ago). I got immediate relief from pain using three gelcap of 100 % saw palmetto berries twice a day.
    Then avoiding all decaf products and drinking dasanti which is reverse osmosis filtered. Chemicals are often used to decaf tea and coffee. Filtered water has fine sediments that even now can hurt me.
    I had urinary infections w blood in my urine for about 10 years. I have now been pain free and UTI free for well over 10 years. I can drink coffee and tea with sugar daily. I just drink my “good” water and there it goes! Hope this helps someone!

      • Sure Grace.
        [email protected]

        Get 100% berries in a gel cap. I get mine at Kroger, Walmart, etc. I am give my alzheimer mother them after 2 months of pseudomonas and many rounds of antibiotics. She is doing better so far. I’m giving her three two times each day.

        I had a friend visiting today and she said she has taken saw palmetto with the first hint of flair up since I told her about it years ago. She says it has taken care of it.
        I also read this week of another female that was instructed by her dr to use saw palmetto to prevent UTIs. She said it kept her from getting them also.

        God bless. If you want more info email me.

  13. This is an email my partner sent to another chronic UTI sufferer. She has an e.coli 4-5 month infection. I hope it helps!

    Just wanted to give you quick update on what I am doing to combat my chronic/recurring urinary tract infection.

    About a month ago, I started going to a Traditional Chinese Medicine Practitioner–specifically, a “5 elements” TCM practitioner. 5 Elements goes a little deeper and is more all-encompassing and more spiritual.

    I was taking an anti-parasite/anti-fungal herbal formula that Dan and I found online when I first started seeing this practitioner. This formula was making me feel great so at first he tried just treating me with acupuncture in hopes that that would be all I needed to clear my UTI. We tried this for about 3 weeks, and I had very minimal UTI symptoms this whole time. Once I finished the anti-parasite/anti-fungal formula, I had a nasty flare up (all of my UTI symptoms returned) so in my next appointment with him, after expressing how desperate I was getting and how much relief I had found on the anti-parasite/fungal formula (yet it still couldn’t kill the infection) — he put me on 7 different homeopathic remedies and an chinese herbal formula for clearing damp heat called Fu Ling Poria.

    His operating theory: I have Gu Syndrome. Due to an onslaught of infection, my immune system is asleep and my digestive system is chronically irritated and not functioning properly (Leaky Gut). Due to the constant stress of a variety of fungal, bacterial and parasitic infections (GU Syndrome) and then an onslaught of antibiotics, my immune system stopped functioning because the battle was too big. So, it doesn’t mobilize aggressively enough to take care of invaders like E. Coli before it is too late. It also doesn’t mobilize to keep me free of additional fungal/bacterial/parasite overgrowths — vicious cycle!

    Each homeopathic I am on serves a different function, but here is my general understanding of what they are doing: the “Unda” formulas I am on operate on a very deep level to clear out the toxic debris from the years of fungal/bacterial/parasite waste and other pollutants. They also support the kidney and improve it’s function which supports the bladder, etc. Then, other homeopathics I am taking stimulate or “reboot” the immune system while another homeopathic formula irritates or “wakes up” the pathogens that are hiding in biofilms so they will come out and be eradicated by the now-functioning immune cells.

    Here are the homeopathic formulas I am on:
    Unda 2
    Unda 7
    Unda 44
    Syntrion – Syinfect Complex
    Staphysagria 9CH
    Cantharis 30k
    Medorrhinum 15c

    My urinary infection symptoms improved dramatically when I started these formulas. My overall health seems to be improving slowly but surely — but that will take longer to repair so I must be patient 🙂 Once my infection is cleared, he plans to keep rebuilding my immune system and my digestive tract.

    • She’s also drinking 64+ oz of herbal antimicrobial, tonifying, supportive tea and taking bee balm tincture which is supposed to help, and strictly adhering to a paleo auto-immune diet.

    • I can relate with this story as I have suffered for nearly 30 years with chronic fatigue syndrome and a host of other issues that go along with it. Chronic kidney inflammation/uti’s are part of this. Auto-immune disorder is the culprit. I have spent fortunes with different holistic practitioners dealing with all of this and am facing another kidney issue. It always creates life-sucking exhaustion. Where is the TCM practitioner your partner has seen? I am familiar with Unda. I began taking the Unda 2 this morning and just started d-mannose powder. How was she advised to take all of these homeopathics? I will check that they fit my picture. The only one I do not have is Syntrion. Also what is the name of the herbal tea she has taken? Thanks for posting.

  14. THANK YOU!!!!!! D-Mannose is a mirscle for e coli infections, I can attest to that. I recently got an e faecali (?) infection and two doses of antibiotics dont seem to have taken care (it still hurts a little) did another test to see if anything shows up. Have ordered your recommended supplements and honestly – this article is a gift from God and an answer to prayer as the doc said that after the next level of antibiotics there is nothing left to do…

  15. It’s one thing to grow bacteria in a test tube, perform a screen in the lab, and find a mutation in the pathogen’s genes. It’s a whole other thing, and much rarer, to find the exact same mutation in nature–in this case, in E. coli in urine samples from some 500 patients suffering from relapsing urinary tract infections.

    The confluent discovery, by University Distinguished Professor Kim Lewis and his colleagues, was published in the journal Nature. It could put people with relapsing UTIs on the fast track for a new therapeutic regimen that Lewis described in an earlier paper.

    “We took a large collection of E. coli isolates from patients with relapsing UTIs,” explains Lewis, who is director of the Antimicrobial Discovery Center. “And we found that quite a number of those isolates had exactly the same mutation–in a gene called hipA–that we and other scientists have seen in test-tube experiments.”

    Pooja Balani, a doctoral student in Lewis’ lab at the time of the study and a first author of the paper, spent countless hours performing a genetic screen, poring over both test-tube cultures of E. coli and patients’ UTI isolates, in search of hipA mutations.

    She was delighted by what she saw: hipA leapt to the fore in both populations.

    The “persister” breakthrough

    An estimated 150 million UTIs occur each year worldwide, accounting for $6 billion in healthcare costs, according to the American Urological Association. The bacterium E. coli is responsible for the majority of them. Antibiotics are the standard treatment, but often the infection returns when treatment is stopped.

    Lewis’ lab had spent years trying to learn why, and in 2001 published a paper that brought the answer into the light of day: A subpopulation of bacterial cells called “persisters” was conferring antibiotic “tolerance.”

    Antibiotic tolerance is distinct from antibiotic “resistance,” which occurs when a pathogen acquires a genetic mutation that allows it to code for a protein that destroys the antibiotic. Think of it this way: With resistance, the bacteria brandish a new killer weapon. With tolerance, the bacteria hide in a foxhole, waiting till the enemy has fled. Then they come out and multiply.

    Bacteria are one-cell organisms. To reproduce, they simply divide: One cell becomes two cells, and so on, until an army of progeny infect the host–here, a person’s urinary tract. But sometimes the division results in one active bacteria cell, which continues to grow and divide, and one that is alive but stops growing–it is dormant, existing in what Lewis calls “a sporelike state.” That is a persister cell.

    “There’s a small subpopulation of persisters that are formed by all pathogens we’ve studied so far,” says Lewis. Because antibiotics attack only actively functioning bacterial cells, he says, persisters escape the onslaught.

    “Persisters are like a bet-hedging defense strategy for bacteria,” says Balani. “Ultimately they save the population.”

    From the lab to the bedside

    Collaborators in the new study included Maria A. Schumacher, Richard G. Brennan, and their students at Duke University School of Medicine, who analyzed the structure of hipA to determine how the mutation increased production of persister cells. What they found was a molecular balancing act gone awry.

    The hipA gene codes for a protein–a toxin. The toxin is usually held in check by another protein, an antitoxin, that is coded for by another gene, hipB. Toxin-antitoxin gene pairs are “scattered around the chromosomes of all bacteria we know of,” says Lewis. A mutation in either gene, however, can throw the balance off kilter. Hence, the more toxin produced by hipA, the more likely the cell will shut down–that is, become a persister. “The hipA mutation gives rise to about 1,000 times more persisters than a gene without it,” says Lewis.

    Knowing this genetic mechanism could enable clinicians to customize treatment for relapsing UTIs. “You can track whether your patient has E. coli with a hipA mutation, and if so, introduce a pulse-dosing regimen,” says Lewis, citing his earlier paper about pulse dosing and the pathogen that causes Lyme disease.

    Pulse dosing, he says, is straightforward: You give the patient an antibiotic and it kills all the growing cells. Then the persister cells start “waking up.” But before they can divide to form a new population, you hit them with the antibiotic again.

    “In a test tube, if you repeat this a couple of times, you can completely eradicate the population,” Lewis says. “I believe that the same thing can be done in people.”

    Maria A. Schumacher, Pooja Balani, Jungki Min, Naga Babu Chinnam, Sonja Hansen, Marin Vulić, Kim Lewis, Richard G. Brennan. HipBA–promoter structures reveal the basis of heritable multidrug tolerance. Nature, 2015; DOI: 10.1038/nature14662

  16. I have had a urinary infection since March 2014, and to date, I have taken over 27 remedies, including two rounds of D Mannous, and two rounds of antibiotics. Currently, I am going to an acupuncture and Chnese herbs physician. I was recently told by a medical medium that I have E.coli and streptococcus in the lining of the urinary track. Since I have both bacteria, I cannot talk Lauricidin. What can I take that would address both the E.coli and the streptococcus? Any other suggestions on this topic would be appreciated. Thank you.

  17. Thanks for the info.

    Beyond what you’ve recommended, you should read up on a new paper in the Journal of Biological Chemistry that identifies the factors that keep the bladder sterile. Apparently, certain polyphenols from various foods and a high urinary pH make all the difference. I wrote about it on my blog, and elaborated from a nutritional perspective.

    I’m not selling anything. This is serious science, and could make all the difference for preventing/treating bladder infection.

  18. I am taking the DMannose and have been since my last infection a month ago…I just got cultured and I have no infection but I still have feelings of having one…so I have now started the Biofilm Disruptor pills (in addition to the D Mannose)..my Urologist had also done 2 weeks ago a cystoscope and everything was normal….he put me on a low dose 50 mg of Macrobid…I am taking that too…but what I do not understand is this…does the Biofilm Disruptor pills kill any bacteria (that is not e coli) of course…just by taking them it kills them or do you have to take something else too to kill the bacteria?