CHRONIC UTIs: WHY PREVENTION AND NON-ANTIBIOTIC TREATMENTS MATTER
REFLECTIONS FROM THE FIRST ALL-PARTY PARLIAMENTARY GROUP MEETING ON UTIs AT WESTMINSTER
I was invited to attend the first policy meeting of the newly established All-Party Parliamentary Group (APPG) on Urinary Tract Infections (UTIs) at Westminster, London.
Walking through the doors of the UK Parliament to discuss chronic and recurrent UTIs was a powerful moment. The room brought together people living with chronic UTIs, clinicians, researchers, charities, and Members of Parliament who are pushing for better outcomes for patients.
My thanks to Dr Allison Gardner MP and Luke Taylor MP, who co-chair the group, and to The Urology Foundation for driving this important work forward.
For many people living with chronic and recurrent UTIs, change cannot come soon enough.
For years, patients have reported feeling dismissed, misunderstood, or caught in a cycle of repeated infections and antibiotics. In many ways, it feels as though not much has changed since I experienced a chronic UTI myself in the late 2000s. This meeting marked an important step in recognising that UTIs are not always simple infections and that better solutions are needed.
WHY THE APPG ON UTIs WAS CREATED
Chronic and recurrent UTIs affect millions of people worldwide, yet UTI diagnosis, treatment, and prevention strategies have not advanced at the same pace as many other areas of healthcare.
The All-Party Parliamentary Group (APPG) on UTIs was established earlier this year to bring together clinicians, researchers, patient groups, and policymakers to address the growing challenge of chronic and recurrent UTIs.
The group aims to raise awareness of the significant health, social, and economic impact of UTIs, while advocating for improvements in UTI diagnosis, treatment options, and prevention strategies.
A key focus is ensuring people living with chronic UTIs have access to:
More accurate diagnostic tools
Better treatment pathways
Stronger research investment into new and non-antibiotic treatment options.
THE IMPORTANCE OF DEFINING CHRONIC UTI
One of the key topics discussed was the need for a clear clinical definition of chronic UTI.
At first glance, this might seem like an academic detail but it’s actually extremely important.
Without agreed definitions, it becomes very difficult to design high-quality clinical trials or evaluate potential treatments properly.
Establishing a clear definition of chronic UTI is therefore a critical step in moving research and policy forward.
This process will take time but it is an essential foundation for meaningful change.
THE NEED FOR BETTER UTI DIAGNOSTICS
Another major theme of the meeting was the need for more accurate and faster diagnostic tools for UTIs.
Current testing methods can sometimes miss infections or fail to detect the full range of bacteria involved. When this happens, patients may be told their test results are “clear” despite ongoing symptoms.
This can lead to delayed treatment, inappropriate treatment, or symptoms that continue for months or even years.
It’s something I experienced firsthand.
What started for me as a UTI never seemed to fully clear. Instead, the symptoms continued, followed by recurring infections. Eventually, I was told I had interstitial cystitis (IC).
Looking back now, and having worked in this field for many years, I firmly believe it was more likely a chronic infection that had never fully resolved, plus recurring UTIs.
Many patients share similar stories of being caught in this diagnostic grey area.
Improving rapid point-of-care diagnostics was identified as a priority so clinicians can make more informed decisions and patients can receive appropriate care more quickly.
In my clinical work, this is one of the reasons we incorporate urinary and vaginal microbiome testing into the Heal Your Bladder programme. These newer testing methods can provide a broader picture of the microbial environment than traditional urine culture tests alone, helping us make more informed decisions about the next steps for each client.
Better testing will be essential if we are to improve both diagnosis and treatment for chronic and recurrent UTIs.
4. WHY WE MUST LOOK BEYONE ANTIBIOTICS IN THE TREATMENT OF UTIs
A particularly important part of the conversation centred around non-antibiotic treatment options.
Antibiotics are an important tool in managing UTIs but relying on them alone is not a sustainable long-term strategy.
Even if new antibiotics were developed, there are two major challenges:
First, the process of developing new antibiotics is slow and expensive, and pharmaceutical companies often have limited financial incentives to invest in them.
Second, bacteria inevitably develop antibiotic resistance. Within a decade of a new antibiotic being introduced, resistance can begin to emerge.
For these reasons, antibiotics alone cannot be the long-term solution to UTI care.
This is why researchers, clinicians, and policymakers are increasingly looking at prevention and non-antibiotic treatments as part of the solution.
CURRENT NON-ANTIBIOTIC TREATMENT OPTIONS FOR UTIs
At present, the main non-antibiotic approaches discussed in clinical settings include:
Methenamine hippurate (Hiprex)
UTI vaccines
Bladder instillations
These approaches are promising. However, one of the frustrations many patients experience is that not all of these options are available in every NHS trust. Access can vary depending on where you live in the UK, creating what many describe as a postcode lottery.
While prevention is often discussed in terms of vaccines or medical interventions, diet and nutritional support can also play an important role in reducing recurrence risk and supporting the body’s natural defences against infection.
This includes strategies such as supporting the urinary microbiome, strengthening the bladder lining, and using targeted supplements that may help reduce the risk of UTI recurrence.
If this is something you’re curious to explore further, I’ve created a free training on UTIs and how to break the cycle, where I explain the food-first and supplement-based approach I use with clients. It’s a helpful place to start if you’re looking for practical ways to support your bladder health.
You can watch the training here
PREVENTING CHRONIC AND RECURRENT UTIs
One of the encouraging themes from the meeting was the growing recognition that prevention must be a priority.
Preventing infections in the first place reduces the need for repeated antibiotic courses and improves quality of life for patients.
This is where lifestyle and nutritional strategies can play an important role.
In clinical practice, we already have several non-antibiotic tools that can support prevention and reduce recurrence risk.
These include:
D-mannose: a naturally occurring sugar that can help prevent certain bacteria from attaching to the bladder wall.
Cranberry extracts (PACs): particularly those standardised for proanthocyanidins, which may help reduce bacterial adhesion.
Plant-derived antimicrobials: certain plant compounds have antimicrobial properties that may help support microbial balance.
Immune and mucosal barrier support through nutrition: nutrients such as vitamin D, zinc, vitamin A, and protein help support the body’s immune defences and epithelial barrier function.
Nutrition is not a replacement for medical care but it can be an important supportive strategy alongside conventional treatment.
Because so many people want practical guidance on where to start, I created a short course called Chronic UTIs: The Root Cause Reset which explores these food-first and supplement-based strategies in more detail. For many people, it can be a helpful next step if they’re looking to support their bladder health alongside medical care.
For many people, these approaches can help reduce recurrence risk and support long-term bladder health.
WHO IS MOST AT RISK OF UTIs?
The meeting also highlighted groups who are particularly vulnerable to urinary tract infections, including:
Older adults living in care homes, where UTIs are common and can sometimes lead to serious complications.
Children who experience recurrent infections, where early diagnosis and appropriate management are especially important.
Improving both diagnostic tools and prevention strategies for these groups will be an important area of future research and policy development.
Better prevention has the potential to reduce repeated infections, antibiotic use, and hospital admissions, particularly in vulnerable populations.
THE FUTURE OF CHRONIC AND RECURRENT UTI RESEARCH AND CARE
The APPG will now review the findings from the James Lind Alliance Chronic and Recurrent UTI Priority Setting Partnership, which identified the top research priorities for patients and clinicians.
You can read the report here.
The next steps will involve identifying both short-term and long-term actions needed to improve care for people living with UTIs and to inform future policy changes, including potential updates to NICE guidance.
Change in healthcare systems rarely happens overnight.
But bringing together patients, clinicians, researchers, and policymakers is how meaningful progress begins.
As someone who works closely with people living with chronic and recurrent UTIs, and who has personally lived through chronic UTIs myself, it was encouraging to see such commitment to improving recognition, research, and care.
WANT TO LEARN HOW TO BREAK THE UTI CYCLE?
If you’re struggling with chronic or recurring UTIs and feel stuck in the cycle of repeated infections and antibiotics, you’re not alone.
I’ve created a free training where I explain:
Why UTIs keep coming back
The underlying factors that are often missed
Practical steps that can help break the cycle
You can watch the free training here: How to Find Lasting Relief from UTI Symptoms (Without Another Prescription).
