Non-antibiotic potential of medicinal plants to combat urinary tract infections

Urinary tract infections (UTIs) are highly prevalent with frequent recurrent episodes. With advances in research and development of modern tools, the pathogenesis of uropathogens is well understood and various associated virulent features have been identified. These include, adherence and invasion of epithelial cells, biofilm formation, quorum sensing, production of certain metabolic enzymes/pigments and release of cytotoxins. Due to increasing reports on antibiotic resistance in UTIs, emphasis is being made on 'nonantibiotic' approaches for treatment of UTI. In recent years, research on traditional plants has gained popularity and medicinal plants are being considered as promising alternatives. Based on the available literature, this review compiles reports on plants and/or their compounds that affect virulent parameters of uropathogens to combat UTI. Along with the virulent features, the immunomodulatory effect of plants to eradicate pathogens is also briefly covered. The use of plants to target virulent mechanism(s), in order to prevent or treat UTI would minimize the increasing drug resistance as well as prevent disruption of healthy gut microbiota.