A Paradigm Shift

Since I started my practice as an Internist,I always take time to let my patients understand their disease , like for example urinary tract infection (UTI), which is one of the most common reasons for consultations in my clinic, how it is acquired, its complications, the medicines for this disease and the role of non-pharmacologic interventions for this condition.

As I was reviewing for my specialty board exam this coming Sunday I came across with the latest Philippine Clinical Practice Guidelines on the Diagnosis and Management of Urinary Tract Infections in Adults 2004. Based on these updated guidelines, I would like to correct some of our assumptions with regards to the non-pharmacologic interventions in preventing and treating UTI:

1. Cranberry juice and cranberry products are not recommended for the prevention and treatment of UTI in population at risk.
2. Lactobacilli both in oral form and vaginal suppositories are not recommended in the prevention of UTI.
3. There is insufficient evidence to recommend oral water hydration in the prevention or treatment of UTI.
4. There is insufficient evidence to recommend coconut juice in the prevention or treatment of UTI.
5. There is insufficient evidence to recommend drinking more water and voiding soon after intercourse to prevent UTI.

I would like to remind my readers that these guidelines I mentioned above cannot encompass all scenarios and under no circumstances should it replace sound clinical judgment of your physicians.