A SINGLE fecal microbiota transplant (FMT) may offer a safe and effective alternative for treating recurrent urinary tract infections (rUTIs), according to a new proof-of-concept study in postmenopausal women. Researchers observed a 68.1% reduction in urinary infection episodes over six months following one oral FMT, suggesting potential for broader use in cases involving multidrug-resistant uropathogens.
Recurrent UTIs remain a widespread issue globally, especially among women, and are increasingly complicated by antibiotic resistance. The investigators hypothesized that modulating the gut microbiome through FMT could reduce colonization by uropathogenic Escherichia coli, thereby decreasing infection risk.
The study enrolled 22 postmenopausal women with a history of rUTIs. All participants received a three-day course of oral rifaximin to reduce existing commensal bacteria, followed by a two-day antibiotic washout. They were then administered a single oral FMT using lyophilized capsules derived from 100 g of freeze-dried stool from a certified donor.
Over the six-month follow-up, urinary tract infections dropped by more than two-thirds compared to baseline. Notably, FMT also led to the eradication of intestinal colonization by multidrug-resistant uropathogens in several patients. Adverse effects were minimal, underscoring the tolerability of this approach.
While the study’s sample size was limited and further validation in larger trials is needed, the results underscore the therapeutic promise of microbiota-based strategies in tackling both recurrent and drug-resistant infections. FMT, already established in the management of Clostridioides difficile infection, may soon expand its clinical utility in urology.
These findings represent a step forward in exploring microbiome modulation as a treatment strategy for persistent infections where conventional therapies often fail.
Reference:
Rico-Caballero V et al. Fecal microbiota transplant as treatment for recurrent urinary tract infections: a proof-of-concept study. Eur J Clin Microbiol Infect Dis. 2025. doi: 10.1007/s10096-025-05202-9. [Online ahead of print]
