Women are hailing ‘miracle cure’ for painful UTIs – but NHS is refusing to fund it. Here’s how to get hold of it, what it does – and supplements you can take to end the misery

Women with persistent, painful bladder infections are being forced to shell out hundreds of pounds for a ‘revolutionary’ vaccine that can prevent the agonising condition from returning – because the NHS currently won’t fund it, say leading experts.

The vaccine, a pineapple-flavoured mouth spray called Uromune, has been show in trials to stop the condition, also known as a urinary tract infection (UTI), for nearly a decade.

Uromune is available at private clinics in the UK, where it costs around £400. It is also in use in a number of other countries such as Spain, Canada and China.

In a handful of cases, the NHS has agreed to fund the vaccine for patients with particularly severe cases of chronic UTIs – where the debilitating infections repeatedly return – who have failed to respond to antibiotics. However, experts say there is now strong evidence that Uromune works best when given as early as possible, raising serious questions about the Health Service’s current limited use of the vaccine.

They are now calling on the NHS to offer Uromune to patients who have suffered at least three UTIs in one year. The move would allow as many as 1.7 million patients living with the chronic condition – the vast majority of whom are women – to access the vaccine for the first time.

It is estimated that the condition leads to 150,000 hospitalisations. Around 6,000 patients die every year due to UTI complications, such as sepsis – a potentially fatal immune system reaction to an infection. UTIs also cost the NHS £380 million annually.

One patient who’s already benefited from Uromune is Jacqui Giles, 69, who has lived with chronic UTIs for 25 years.

The former secretary from Oxfordshire would get a UTI roughly every six weeks.

‘Until you suffer with it you really can’t understand quite how painful it is,’ says Jacqui, who adds that she was reliant on painkillers to get through the day.

‘I’d have pain in my hip and back which meant I struggled to walk. I felt like half the woman I was before and I would feel drained – in all I was completely fed up.’

Doctors repeatedly prescribed Jacqui with antibiotics, hoping that it would rid her of the bacteria causing the pain, but despite countless trips to her GP the infection kept returning.

‘I felt like a nuisance,’ says Jacqui. ‘I was not taken seriously by the doctors at all, they just kept issuing me antibiotics and it would keep returning. In the end I was living in fear – you are told that things like alcohol or sugar can trigger it, so you avoid everything in case it might cause it to return.

‘Having a social event in the calendar would cause anxiety, as I’d worry in the weeks leading up to it when I would be struck by one again.’

It was only when Jacqui went for a private gynaecology appointment that the doctor recommended she try Uromune.

She paid £400 for the mouth spray, which is applied under the tongue every day for three months, and says there were no side effects.

In the year since the treatment, Jacqui has had just three infections, with few noticeable symptoms, and which were quickly banished by a short course of antibiotics and drinking plenty of fluid.

‘I don’t dread waking up every morning now,’ says Jacqui. ‘I feel so much better. I can also now go back to being active, walking my dog, gardening and looking after my grandchildren.’

Experts say that, while it is unusual for a patient with such a long-standing UTI problem, such as Jacqui, to respond so well to Uromune, there are hundreds of thousands of women who would almost certainly benefit from it.

‘If this drug gets approved it would be revolutionary for recurrent UTI patients,’ says

Mr Bob Yang, consultant urology surgeon and lead Uromune researcher at the University of Oxford. ‘These patients suffer from a debilitating condition, but are just handed antibiotics which are not effective for most people.’

Mr Yang also practises at Circle Reading Hospital – a private hospital – where clinicians are already prescribing the spray.

He adds: ‘We’ve seen in clinic the transformative impact Uromune can have.

‘When used early – before the condition becomes chronic – it can prevent re-infection, which would stop patients spending years on antibiotics and suffering from debilitating long-term infections.’

The need for more UTI treatments is clear. They are among the most common infections in the UK, affecting more than a million people every year.

Symptoms include burning pain when passing urine and feeling the urge to use the toilet when the bladder is empty.

The infections occur when bacteria enters the urethra – or urinary tract – the duct that transports urine out of the body from the bladder.

Around four out five UTIs are triggered by E. coli, a kind of bacteria that is regularly found in food. Earlier this year, US research concluded that E. coli-contaminated meat – particularly chicken and turkey – could be driving a rise in UTI infections. Typically, this bacteria lives harmlessly in the gut, but it can cause an infection if it reaches the urinary tract.

Women are more likely to suffer UTIs because they have shorter urethras than men, meaning it’s easier for bacteria to reach the bladder. This risk further increases after the menopause due to the falling levels of the female sex hormone oestrogen, which can help fend off the bacteria.

For most, a short course of antibiotics will clear up a UTI within days. However, for a growing number of Britons the infection will repeatedly return.

Experts believe this occurs when the bacteria stops responding to antibiotics. This means that, though the infection’s severity

will be temporarily reduced, the bacteria is not destroyed.

As a result, chronic UTI patients – which the NHS classes as anyone who experiences three or more infections a year – can spend much of their lives on repeated courses of antibiotics. Over time, this can lead to serious side effects (see panel on right).

Experts say that, for these patients, Uromune could be life-changing.

The vaccine works by triggering the immune system into recognising four of the most common bugs that cause UTIs. Along with E. coli, this includes Klebsiella pneumoniae, Proteus vulgaris and Enterococcus faecalis. The bugs are inactivated – meaning they’ve been killed by scientists so they cannot cause disease, but are still recognised by the immune system to create antibodies.

Last year, The Mail on Sunday was first to report the results of

a long-running Uromune trial involving 89 patients with recurrent UTIs. The study found that, over a nine-year period, half of them remained entirely free

of infection.

The researchers found that around 40 per cent of patients needed a second dose after two years, and for those who did suffer repeat infections they were easily treated.

This newspaper understands that the drug’s developer, Spain-based pharmaceutical firm Immunotek, has filed for approval with the UK regulator, the Medicines and Healthcare products Regulatory Agency (MHRA).

Once the vaccine has the green light from the MHRA, it will then be up to the NHS spending watchdog, the National Institute for Health and Care Excellence (NICE), to decide whether the Health Service will fund it.

However, experts say it could still be years before Uromune receives NHS approval, and argue that patients should not be left to suffer in the meantime.

‘Many other countries like Canada and Hong Kong are far ahead of us here in the UK,’ says Mr Yang. ‘Even though the drug is not licensed there either, they’re able to offer Uromune at specialist centres to far more patients. Here, many patients are still dealt with in primary care [by GPs] where the first port of call is antibiotics.

‘We know it’s safe and effective, but due to a slow approval process there are few patients able to get the drug in this country and the majority have to go privately.’

Critics, though, say it’s too early for Uromune to be widely rolled out – particularly as it is more expensive than current treatments. The NHS calculates the vaccine would cost £326 per course, compared to around £50 for a round of antibiotics.

‘Uromune has shown real promise, even when compared to similar vaccines being developed’, says Professor Jennifer Rohn, the head of the Centre for Urological Biology at UCL. ‘However, it’s still early stages and at the moment we do not really know why the drug works for some and not others.’

Yet charities point out that the drug is already being offered privately in the UK, meaning that only the well-off have the chance to find out whether it will work for them.

‘Chronic UTI patients are desperate and are being forced to turn to private treatment, which is not acceptable,’ says Carolyn Andrew, co-director of the Chronic Urinary Tract Infection Campaign. ‘Uromune should be made available on the NHS.

‘It won’t work for everyone, but we need a personalised approach to the condition. That would involve this drug as well as antibiotics and a better testing regime, to make sure UTI patients are spotted early.’

Research shows that the current urine test used by NHS GPs misses around two-thirds of UTIs. This leads to delays in diagnosis, which raises the risk of infection becoming resistant to antibiotics.

Campaigners say that improved testing would be crucial for an effective roll-out of Uromune.

In the meantime, experts say there are some steps patients can take to reduce their risk of recurrent infections.

One option is a 50p supplement called D-mannose – a form of sugar molecule found in some fruits and vegetables but which is also sold as a dietary supplement, in tablets or powder form. It is not absorbed by the body and is quickly excreted in urine. Some experts think that, while passing through the urinary tract, the molecule binds to harmful bacteria which are then flushed away before they can cause infection.

‘It’s a bit like rolling a sticky dough-ball in flour,’ says Dr Catriona Anderson, a GP and UTI specialist. ‘The bacteria – especially E.coli – bind to the D-mannose molecules rather than to bladder cells.’

A German study published in 2022 in the journal Antibiotics, found that, in patients with a bladder infection, D-mannose produced ‘very good clinical cure rates’.

‘It will not be big enough guns to treat big flaring infections,’ says Dr Anderson. ‘But for the majority of patients, particularly when used alongside antibiotics, it can be really effective.’

Probiotics – supplements containing live bacteria and yeast – may also help. While this may sound counterintuitive, boosting levels of ‘healthy’ bacteria in the gut can reduce the risk of UTIs.

‘The gut plays a big role in UTIs, as we now know that the bacteria that cause UTI can come from the environment before making their way into the bladder,’ says Professor Rohn.

‘When there is less healthy bacteria in the gut, this gives potentially harmful bugs like E. coli the chance to multiply.’

Popular probiotics on sale in high street pharmacies include Symprove and Bio-Kult.

There’s also evidence that avoiding certain food or drink can help reduce UTI flare-ups – these don’t cause UTIs on their own, but can irritate the bladder, reducing the immune system’s ability to fend off new infections.

‘For some, this is citrus fruits or fizzy drinks, but also alcohol and coffee,’ says Dr Anderson.

However, for Jacqui Giles, this was one of the biggest benefits of Uromune – she no longer lives in fear of what might trigger the next infection.

‘It feels like I’ve got my life back,’ says Jacqui. ‘It’s the little things. Now I can have a glass of champagne or even a can of coke without being frightened that it would trigger another infection.

‘I can enjoy myself now.’