EC Nutrition

Recurrent urinary tract infections (UTIs) are common among women and frequently result in repeated antibiotic exposure, high- lighting the need for non-antibiotic preventive strategies. This randomized, double-blind, placebo-controlled, parallel, multicenter study evaluated the efficacy and safety of oral Akkermansia muciniphila VHAKM (NugensiaTM) in women with recurrent UTI. Sixty participants were randomized 1:1 to receive A. muciniphila VHAKM (1 × 109 CFU/day) or placebo for 60 days. The reported mean number of symptomatic UTI episodes per participant was lower with A. muciniphila VHAKM than placebo (0.87 ± 0.73 vs. 1.32 ± 0.82; p = 0.014), and fewer participants experienced at least one symptomatic UTI (50.0% vs. 76.7%; p = 0.031). Culture-positive UTI, antibiotic use, and rescue-medication use were also significantly lower in the intervention group. Improvements in the Typical, Differential, and Quality-of-Life domains of the Acute Cystitis Symptom Score were significantly greater with A. muciniphila VHAKM than placebo (all p < 0.05). Following treatment, the intervention group showed lower measured levels of Escherichia coli and Proteus mirabilis and higher levels of Bifidobacterium, accompanied by a reduction in vaginal pH. No serious adverse events or treatment- related discontinuations were reported. These findings support further investigation of A. muciniphila VHAKM as a potential non- antibiotic strategy for reducing recurrent UTI and associated urogenital symptoms in women.

Keywords: Akkermansia muciniphila VHAKM; Nugensia; Urinary Tract Infection; UTI; Probiotic

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