Said RM, Wissa AA, Wahib ST, Hashem NU. Bovine colostrum for prevention of recurrent urinary tract infections in susceptible children: A randomized controlled trial. World J Clin Pediatr 2026; 15(3): 118300 [DOI: 10.5409/wjcp.118300]
Corresponding Author of This Article
Ragia M Said, Professor, Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Ain Shams University, Abbaseyah, Cairo 1181, Egypt. ragia_marei@med.asu.edu.eg
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
research-article
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Pediatr. Sep 9, 2026; 15(3): 118300 Published online Sep 9, 2026. doi: 10.5409/wjcp.118300
Bovine colostrum for prevention of recurrent urinary tract infections in susceptible children: A randomized controlled trial
Ragia M Said, Abanoub A Wissa, Sara T Wahib, Noha U Hashem
Ragia M Said, Noha U Hashem, Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo 1181, Egypt
Abanoub A Wissa, Clinical Pharmacy, Faculty of Medicine, Ain Shams University, Cairo 1181, Egypt
Sara T Wahib, Department of Pediatrics, Ain Shams General Hospital, Ministry of Health., Cairo 11511, Egypt
Co-corresponding authors: Ragia M Said and Noha U Hashem.
Author contributions: Said RM, Hashem NU designed the research study; Wahib ST, Hashem NU, Wissa AA performed the research; Wahib ST, Hashem NU collected the data; Hashem NU wrote the manuscript; all authors have read and approve the final manuscript; Said RM and Hashem NU have played important and indispensable roles in the manuscript preparation as the co-corresponding authors.
Institutional review board statement: This study was approved by the Institutional Review Board, Faculty of Medicine, Ain Shams University (No. FWA000017585; FMASU MS244/2023).
Clinical trial registration statement: This trial was registered at ClinicalTrials.gov. The registration identification number is (NCT06164600).
Informed consent statement: All legal guardians of all patients involved in the study provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no competing interests to declare that are relevant to the content of this trial.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Data sharing statement: The datasets generated and analyzed during the current study are not publicly available because individual privacy could be compromised. However, they are available from the corresponding author on reasonable request.
Corresponding author: Ragia M Said, Professor, Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Ain Shams University, Abbaseyah, Cairo 1181, Egypt. ragia_marei@med.asu.edu.eg
Received: December 29, 2025 Revised: January 27, 2026 Accepted: March 17, 2026 Published online: September 9, 2026 Processing time: 215 Days and 1.5 Hours
Abstract
BACKGROUND
Recurrent urinary tract infections (UTIs) in children with congenital anomalies of the kidney and urinary tract (CAKUT) are a major cause of deterioration of kidney functions and possibly, renal scarring. Rising antimicrobial resistance necessitates alternative preventive strategies. Bovine colostrum (BC), a bioactive prebiotic, has emerged as a promising adjuvant therapy in upper respiratory and gastrointestinal (GIT) infections. Given the shared mucosal immune mechanisms, the urinary tract may represent a suitable target for this preventive strategy to reduce UTI recurrence.
AIM
To evaluate the potential role of oral BC as an adjuvant therapy for preventing recurrent UTIs in children with CAKUT.
METHODS
This randomized, double-blinded, placebo-controlled trial enrolled 60 children (< 18 years) with CAKUT and culture-confirmed recurrent UTIs. Children with urinary stones or endo-urinary devices were excluded. Participants were randomized to receive either oral BC sachets (n = 30) or placebo (n = 30) daily for one month. All patients were followed monthly for six months for UTI symptoms, physical examination, urine analysis, urine culture and sensitivity, complete blood count and C-reactive protein when indicated.
RESULTS
The two study groups were comparable in age, sex, and chronic kidney disease stage (P > 0.05). Colostrum supplementation showed a nonsignificant reduction in the overall incidence of upper and lower UTIs vs placebo over six months [relative risk (RR) = 0.84, 95%CI: 0.63-1.12; P = 0.22]. However, significant reductions of 73%-75% in UTI incidence were observed during the fourth, fifth, and sixth months of follow up (P < 0.05 for each). When stratified by infection type, cystitis incidence was significantly lower in the colostrum group (43.3% vs 70.0%; RR = 0.62; 95%CI: 0.39-0.99; P = 0.037), while no significant difference was observed in pyelonephritis. GTI and respiratory infections were reduced by 34% (RR = 0.66; 95%CI: 0.50-0.87; P = 0.001). No allergic reactions were reported.
CONCLUSION
BC supplementation may reduce cystitis, as well as respiratory and GIT infections, in children with CAKUT. The observed month-specific reduction in UTIs suggests a possible cumulative benefit with continued supplementation, warranting further research.
Core Tip: Recurrent urinary tract infections (UTIs) promote the progression of kidney damage in children with congenital anomalies of the kidney and urinary tract, potentially leading to chronic kidney disease. The rising burden of antimicrobial resistance highlights the need for effective nonantibiotic preventive strategies. This randomized, double-blinded, placebo-controlled trial explores oral bovine colostrum (BC), a bioactive prebiotic with immunomodulatory properties, as an adjuvant therapy in these children. Although overall UTIs reduction was not statistically significant, BC significantly reduced cystitis, and showed delayed, month-specific reductions in UTIs, alongside fewer respiratory and gastrointestinal infections. These findings suggest a potential cumulative immunomodulatory benefit of BC in vulnerable pediatric populations.
