Efficacy of N-acetylcysteine, D-mannose and Morinda citrifolia to Treat Recurrent Cystitis in Breast Cancer Survivals.

BACKGROUND/AIM Breast cancer survivors in adjuvant therapy, frequently experience the estrogen deficiency with genitourinary symptoms mostly represented by recurrent bacterial cystitis. The objective of the present study was to evaluate the effectiveness of N-acetylcysteine, D-mannose and Morinda citrifolia fruit extract (NDM), when associated to antibiotic therapy, in reducing the persistence of recurrent cystitis in this risk population. PATIENTS AND METHODS Sixty breast cancer survived women with recurrent cystitis were retrospectively examined. Group 1, comprised of 40 patients treated with antibiotic therapy associated with NDM lasting for six months, Group 2 comprised of 20 patients treated with antibiotics alone. RESULTS The use of NDM in combination with antibiotic therapy showed a significant reduction in positive urine cultures, compared to antibiotics alone. Subjects of Group 1 rather than those of Group 2, showed improvement in symptoms score of urgency, frequency, urge incontinence, recurrent cystitis, bladder and urethral pain. CONCLUSION In breast cancer survived women affected by genitourinary discomfort, the combination of NDM and antibiotic therapy showed a greater efficacy in reducing urinary tract infections and urinary discomfort with respect to antibiotic use only.

[1]  Jason D. Wright,et al.  Utilization of gynecologic services in women with breast cancer receiving hormonal therapy , 2017, American journal of obstetrics and gynecology.

[2]  G. Palleschi,et al.  Prospective study to compare antibiosis versus the association of N-acetylcysteine, D-mannose and Morinda citrifolia fruit extract in preventing urinary tract infections in patients submitted to urodynamic investigation. , 2017, Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica.

[3]  N. Biglia,et al.  Genitourinary Syndrome of Menopause in Breast Cancer Survivors: Are We Facing New and Safe Hopes? , 2015, Clinical breast cancer.

[4]  D. Portman,et al.  Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women’s Sexual Health and The North American Menopause Society , 2014, The journal of sexual medicine.

[5]  D. Portman,et al.  Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women's Sexual Health and The North American Menopause Society , 2014, Climacteric : the journal of the International Menopause Society.

[6]  D. Papeš,et al.  d-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial , 2014, World Journal of Urology.

[7]  C. Tinelli,et al.  Oral D-mannose in recurrent urinary tract infections in women: a pilot study , 2014 .

[8]  L. Huelves,et al.  Effects of human serum albumin, ibuprofen and N-acetyl-L-cysteine against biofilm formation by pathogenic Escherichia coli strains. , 2010, The Journal of hospital infection.

[9]  J. Versalovic,et al.  Novel synergistic antibiofilm combinations for salvage of infected catheters. , 2009, Journal of medical microbiology.

[10]  Kazumi Matsumoto,et al.  Anti-inflammatory and potential cancer chemopreventive constituents of the fruits of Morinda citrifolia (Noni). , 2007, Journal of natural products.

[11]  A. Schito,et al.  Effect of fosfomycin alone and in combination with N-acetylcysteine on E. coli biofilms. , 2003, International journal of antimicrobial agents.

[12]  E. Furusawa,et al.  An immunomodulatory polysaccharide‐rich substance from the fruit juice of Morinda citrifolia (noni) with antitumour activity , 1999, Phytotherapy research : PTR.

[13]  K. Lewis,et al.  Persister cells. , 2010, Annual review of microbiology.