Recurrent UTI After First-Line Failure: What’s Next? | Prof. Chris Harding with Live UTI Free (LUF)

In this episode of the Live UTI Free Podcast, host Melissa Kramer talks with Professor Chris Harding, Consultant Urological Surgeon at Newcastle upon Tyne Hospitals NHS Foundation Trust and Professor of Urology at Newcastle University.

They explore the VESPER clinical trial, a landmark study for people with recurrent urinary tract infections (RUTIs) who haven’t improved with first-line prevention. Together, they discuss how bladder instillations work at home, why this trial focuses on real-world symptoms rather than lab culture results, who can participate, and how the findings could inform future care guidelines across the UK.

Key Takeaways

• Three prevention options tested side by side. The VESPER trial compares daily oral antibiotics, bladder-administered gentamicin, and GAG-layer replacement therapy, designed to strengthen the bladder’s natural protective coating.
  
  
  
• Targeted treatment results in fewer whole-body side effects. Delivering medicine straight into the bladder keeps it where it’s needed most. In earlier studies, gentamicin wasn’t detected in the bloodstream, suggesting a low risk of systemic side effects.
  
  
  
• Measuring what matters most. Instead of relying on unreliable culture tests, success is defined by symptoms and treatment outcomes, reflecting how people actually experience UTIs in daily life.

If you or someone you support meets the criteria and is in the UK, discuss a referral specifically for the VESPER trial with your GP.

Want to learn more about urinary health? Visit LiveUTIFree.com for expert articles on the latest research, or check out our YouTube channel for a video format.