Background: Urinary tract infection (UTI) is a renal infection that affects the urinary tract and is global problem related to health and many people are affected each year at some points of their lives. Modern studies about urinary tract infections show that almost one third of the world's population has been suffering from this ailment. Different antibacterial medicines have been reported to have resistance against pathogens. In order to overcome the problem, exploration for new and dynamic antibacterial agents from natural sources is the emerging trend. 

Primary study objective: The primary objective was to evaluate the efficacy and safety of the polyherbal test drug formulation, "Crano-cure", as treatment for UTIs. 

Methods/design: In the current study, clinical trials were designed to evaluate the effects of the polyherbal formulation "Crano-cure" compared to the standard drug Ciprofloxacin in randomized, controlled multicenter trial of 205 patients, analyzing clinical outcomes and safety profiles. 

Setting and participants: Conducted across multiple centers, including Shifa-ul-Mulk Memorial Hospital at Hamdard University Karachi and three other clinics, the study involved 205 patients aged 15-60, irrespective of their socioeconomic status. 

Intervention: Patients were classified into two groups i.e. control group (ciprofloxacin) and the test group (crane-cure). Polyherbal formulation of 500 mg Crano-cure capsules two times in a day were administered to the test group for 28 days. The control group was administered a control ciprofloxacin tablet 500 mg two times in a day for 28 days. 

Primary outcome measures: The drug was found safe for further clinical study after observing changes or improvements in UTI symptoms, urine culture and blood complete tests. The clinical trial was dully registered on the US National Library of Medicine, ClinicalTrials.gov Identifier: NCT04575493. The trial was accompanied in the instructions of EC (Ethical Committee). The study plan and procedures were displayed to the BASR (Board of Advance Studies and Research) and board members of the Ethical Committee (EC), which was ERB-2021-9-1. 

Results: Clinical study results revealed the effectiveness of Crano-cure in the management of UTIs symptoms and hematological and biochemical parameters including blood complete test, liver function tests, renal function tests and lipid profile. Moreover, the test drug Crano-cure revealed a significance level (P ≤ .05) in compliance and cost-effectiveness compared to control ciprofloxacin.

Background: Improving the efficiency of treatment and prevention of recurrent lower urinary tract infection (LUTI) is an important problem in modern urology. A significant role is given to the non-antibiotic measures. 

Aim: To evaluate the clinical and microbiological efficiency of the drug Urolife-Next in patients with recurrent UTI. 

Materials and methods: A total of 70 women with recurrent UTI aged 18 to 55 years (mean 35.1+/-10.1) and symptoms of cystitis were included in the study. After antibacterial therapy, all patients were divided into 3 groups. In the group 1 (n=24), patients took Urolife-Next 1 capsule 3 times a day for 90 days, in the group 2 (n=23) Urolife-Next in the same dose, but for a period of 30 days, while patients of group 3 (n=23) did not receive any treatment. The total follow-up period was 90 days. Frequency and severity of symptoms of recurrent UTI were assessed. The microbiological part of the study included evaluation of the presence and severity of anti-adhesive, anti-biofilm and direct antibacterial effects of the Urolife-Next against uropathogens isolated from urine of patients with exacerbation of UTI. 

Results: In group 1, in which patients took Urolife-Next throughout the study, the lowest frequency of relapses was seen. During the 90-day follow-up, recurrences of UTI occurred in only 3 (12.5%) patients in group 1, compared to 18 (78.3%) in group 3. In addition, in the group 1 there was a significantly lower severity of symptoms during exacerbation of cystitis compared to the initial episode, as well as to 3. Urolife-Next showed antibacterial activity against 29 (41.4%) of 70 strains of uropathogens. The minimum inhibitory concentration of Urolife-Next against gram-negative microorganisms was on average 2 times higher than for gram-positive pathogens. A pronounced anti-adhesive activity of Urolife-Next in vitro was also revealed. The maximum anti-adhesive effect was observed 2 hours after the start of the study. By this time, the adhesion index for cultures in the presence of Urolife-Next was 2.3 times lower than the control values for E. coli, 2.5 times for Kl. pneumoniae, and 2.9 times for E. faecalis. Significant antibiofilm activity of Urolife-Next was also noted. The severity of biofilm formation, which was assessed by changes in the optical density of cultures, decreased by 1.3-2.2 times, depending on the type of uropathogens. 

Conclusions: The results of the study prove the efficiency of the dietary supplement Urolife-Next for the prevention of recurrences in patients with UTI. Its components (D-mannose, cranberry extract, vitamins D and C, hyaluronic acid, probiotics) influence the main pathogenetic factors.