A comprehensive review of urinary tract infections: pathophysiology, antibiotic resistance, and therapeutic strategies, with emphasis on herbal alternatives

Urinary tract infections (UTIs) are pervasive and affect individuals of all ages, presenting a significant global health concern. The rise of antibiotic-resistant bacteria, recurrent infections, and the associated economic burden necessitate a comprehensive understanding of UTI pathophysiology and therapeutic approaches. This review explores epidemiology, risk factors, and the microbiology of UTIs. It delves into antibiotic and nonantimicrobial therapies, emphasizing the challenges posed by bacterial resistance. The authors scrutinize herbal medicines as alternatives to combat multidrug resistance, discussing their safety, potential benefits, and limitations. The review calls for innovative strategies, including vaccine development, and stresses the importance of antibiotic stewardship. Methodologically, the review incorporates diverse sources and databases, offering a comprehensive synthesis of current knowledge. In conclusion, the authors advocate for continued research into novel UTI therapies, considering the complexities of bacterial resistance and the promising role of medicinal plants in addressing this global health challenge. Afterwards, a total of 134 articles from the years 2010 to 2024 were used to create the final bibliometric dataset. Griffith University is an exceptionally productive university, demonstrating significant worldwide impact. Terreni M. is recognized as the author with the greatest number of published works, while the work written by Azami et al. in 2019 is considered the most impactful publication. The purpose of these outcomes is to offer a comprehensive comprehension of UTIs and the utilization of herbal medications as inhibitors of multidrug resistance.