A Novel Probiotic-antibiotic Combination to Prevent Recurrent Urinary Tract Infections

Inclusion Criteria:

• A history of 3 or more UTI episodes in the past 12 months, or 2 or more episodes inthe past 6 months

• no evidence of vesicoureteral reflux or only low-grade (grade 1-2) vesicoureteralreflux

• no other genitourinary anatomical abnormality

• not receiving prophylactic antibiotics at the time of enrollment

• Ages 2-17 years.

Exclusion Criteria:

• high grade (grade 3-5) vesicoureteral reflux

• neurogenic bladder

• anatomical abnormalities of the gastrointestinal tract

• any history of urologic or gastrointestinal surgery

• on prophylactic antibiotics

• a urine culture positive for pathogens that are not susceptible to ciprofloxacin inthe last 3 months

• history of an allergic reaction to ciprofloxacin or other quinolones, or a historyof severe adverse reactions

• As stated on the package insert for Ciprofloxacin, individuals with a known historyof myasthenia gravis should avoid taking Ciprofloxacin and therefore will beexcluded from this study.

• Based on the black box warning for Ciprofloxacin, individuals taking tizanidine asconcomitant administration, or those taking other drugs known to interact withciprofloxacin will be excluded from the study.

• individuals with known QT prolongation, hypokalemia, or on other drugs that prolongthe QT interval should also avoid taking Ciprofloxacin and will be excluded fromthis study.

• Individuals under 2 years old. In the BFIT clinic, because they do bladder, bowelmovement, and constipation management, it is harder to manage if the patient is notpotty trained. Therefore, we are excluding participants under 2 years of age.