Use of mebendazole (anthelmintic) for recurrent uncomplicated urinary tract infections in a healthy female: A case report.

Abstract

Background: Recurrent uncomplicated urinary tract infections (UTIs) in healthy females pose a significant challenge to both patients and healthcare professionals, due to the need for repeated antibiotic treatments and the recurrence of symptoms and suffering. This case report suggests a potentially simple approach to treating recurrent uncomplicated UTI in a healthy, sexually active female, which, if validated, may eliminate the need for frequent antibiotic courses and long-term prophylactic use, potentially leading to a complete cure.

Case presentation: A 35-year-old healthy, sexually active Middle Eastern female was diagnosed with a recurrent uncomplicated UTI. The patient received multiple courses of culture-guided antibiotics, including ertapenem, for over a period of two years. The patient inadvertently recovered from the disease after she and her family received mebendazole treatment, following the diagnosis of a pinworm infestation in her five-year-old child. All patients' symptoms resolved, with no recurrence of urinary tract infections or need for antibiotics during the two-year follow-up period after mebendazole administration. The patient remained sexually active throughout the follow-up period without any lifestyle modifications.

Discussion: Recurrent urinary tract infections (rUTIs) in healthy females remain a significant medical challenge as there is no established hypothesis to explain why some women are more susceptible to rUTIs than others. While pinworm (Enterobius vermicularis) is a well-recognized parasite, research has primarily focused on its effect on children - with few studies investigating its impact on the adult population. This may be attributed to the fact that pinworm infections in adults are mostly self-limiting and asymptomatic. However, some case reports have documented complications arising from pinworm.

Conclusion: This case raises the question of whether empirical treatment with mebendazole should be considered for recurrent uncomplicated UTIs in sexually active, healthy females - alongside standard antibiotic therapy. Identifying pinworm infection in healthy adult females with rUTIs could provide valuable insights, particularly if an association between the two is confirmed.