Translate this page into:
A pilot study on analysing the efficacy of homoeopathic medicine Terebinthinae oleum 30 C in managing acute lower urinary tract infection
*Corresponding author: Dr. R. A. Sibin, Department of Organon of Medicine, Sarada Krishna Homoeopathic Medical College, Kanniyakumari, Tamil Nadu, India. sibinra1@gmail.com
-
Received: ,
Accepted: ,
How to cite this article: Sibin RA, Murugan M, Janani S, Rachana Mol RS. A pilot study on analysing the efficacy of homoeopathic medicine Terebinthinae oleum 30 C in managing acute lower urinary tract infection. J Integr Stand Homoeopath. doi: 10.25259/JISH_45_2025
Abstract
Objectives:
Urinary tract infection (UTI) occurs when bacterial microorganisms establish and multiply within the urinary tract. Uropathogenic Escherichia coli strains cause most UTIs. The administration of antibiotics has led to the emergence of various antibiotic-resistant bacterial strains. This highlights the need for an alternative treatment option. This study aims to analyse the therapeutic efficacy of Terebinthinae oleum 30 C in acute lower UTI in young adults through urine deposit analysis, dipstick, enumeration of bacterial load and symptomatologic improvement by UTI symptom and impairment questionnaire-8 (SIQ 8) questionnaire.
Material and Methods:
Five cases of UTI, between the ages of 18 and 25 years, were prescribed with Terebinthinae oleum in 30 C potency, seven doses, one dose in 10 mL aqua, ten gtt, to be taken orally in TID, for 7 days. The assessments were made on the 1st, 3rd and 7th days. The urine deposits, the dipstick values, the symptomatic improvements based on the UTI SIQ 8 Questionnaire and the enumeration of bacteria load in the urine sample by serial dilution agar plating method were used to prove the efficacy of Terebinthinae oleum 30 C.
Results:
In all 5 cases, improvement was seen in urine deposit parameters, dipstick parameters, reduction in bacterial colony-forming unit and UTI SIQ 8 scoring before, during and after treatment.
Conclusion:
This study suggests that Terebinthinae oleum 30 C is efficacious in managing lower UTIs, as evidenced by its effectiveness in addressing symptomatology, laboratory parameters and microbiological responses in urine culture.
Keywords
Anti-biotic resistance
Lower urinary tract infection
Serial dilution agar-platting
Terebinthinae oleum
INTRODUCTION
Urinary tract infections (UTIs) are a clinical condition commonly seen in primary care centres, in which bacterial microorganisms are established and multiply within the urinary tract tissues, extending from the urethral orifice to the renal cortex.[1,2] The prevalence of UTI varies from 21.8 to 31.3% in various parts of India.[3,4] The increasing prevalence of antibiotic-resistant uropathogenic bacteria poses a significant challenge in the management of acute lower UTIs. Conventional treatment relies heavily on antibiotics, but the emergence of multidrug-resistant strains has reduced treatment efficacy and increased recurrence rates. This necessitates the exploration of alternative or complementary treatment options that are effective, safe and less likely to contribute to resistance.[5] Conventional treatment for UTIs typically results in either the complete eradication of pathogens or a reduction in bacterial counts, depending on the sensitivity of the bacteria to the prescribed antibiotics.[6]
However, rising antibiotic resistance can lead to persistent or secondary infections. In this aspect, homoeopathy could provide a gentle, economically viable treatment with minimal adverse effects. Homoeopathic remedies like Terebinthinae oleum 30 C focus on symptom relief without contributing to resistance. Comparative culture analysis of both treatments can highlight differences in efficacy and resistance patterns. In addition, homoeopathy offers a cost-effective alternative, as it reduces the need for repeated antibiotic courses, minimises side effects and lowers overall healthcare expenses. Recent studies have evaluated the efficacy of homoeopathic medicine as prophylaxis for UTIs.[7] Studies have suggested that homoeopathic medicines are effective in managing acute UTIs in females.[8] Terebinthinae oleum, derived from turpentine oil, has been historically used in homoeopathy due to its affinity for the urinary system, particularly for treating symptoms of UTIs, including dysuria, frequent urination and urgency. Terebinthinae oleum is a commonly prescribed homoeopathic medicine for UTI on the clinical side.[9,10] This study suggests the efficacy of Terebinthinae oleum in 30 C potency in symptomatic management, laboratory parameters and reduction in the bacterial load through urine culture.
However, there is limited published evidence validating its efficacy in acute UTIs. This study seeks to bridge this gap by:
Evaluating the clinical efficacy of Terebinthinae oleum 30 C in acute lower UTIs.
Correlating symptomatologic improvements with objective microbiological and laboratory findings.
Establishing a preliminary scientific foundation for future large-scale trials on homoeopathic UTI management.
By integrating clinical, microbiological and laboratory-based assessments, this study aims to provide preliminary but tangible evidence of homoeopathy’s role in UTI treatment, offering a safer and individualised therapeutic alternative in the face of rising antibiotic resistance.
A thorough assessment of treatment efficacy should encompass microbiological findings, bacterial culture analysis and validated symptom evaluation tools. The symptom and impairment questionnaire-8 (SIQ-8) questionnaire is a reliable measure of symptom severity and treatment response, complementing laboratory parameters. Furthermore, the analysis of cellular changes, including variations in pus cell and epithelial cell counts, provides insight into infection resolution. Integrating clinical, microbiological and symptomatic assessments offers a comprehensive understanding of treatment outcomes and their broader implications in UTI management.
Unlike most homoeopathic studies that primarily focus on symptom relief, this research correlates subjective improvements (UTI SIQ-8 scoring) with objective measures, such as urine deposit analysis, dipstick parameters and bacterial enumeration through culture. This strengthens the scientific validity of homoeopathic intervention by integrating laboratory-based outcomes. By assessing bacterial load reduction, this study hints at possible immune-modulatory or antimicrobial properties of Terebinthinae oleum, opening new avenues for research on its mechanism of action at a cellular level.
MATERIAL AND METHODS
Inclusion criteria
Participants between 18 and 25 years of age (young adults).
Both male and female participants.
Participants were clinically diagnosed with acute lower UTI based on symptoms (e.g., dysuria, frequency, urgency, lower abdominal pain).
Only patients presenting with symptoms of acute UTI within the last 48 h at the time of enrolment.
Exclusion criteria
Participants with severe UTIs (e.g., pyelonephritis or complicated UTI, characterised by fever, chills and flank pain) or systemic symptoms indicating sepsis.
Pregnant or breastfeeding women due to potential unknown effects of homoeopathic remedies on foetal development or infant health.
Participants with known anatomical abnormalities, urinary tract stones or other underlying urological conditions.
Individuals with compromised immune systems (e.g., due to human immunodeficiency virus, diabetes, immunosuppressive therapy, cancer treatments, etc.).
Participants with a history of recurrent or chronic UTIs (defined as more than 3 infections/year).
Patients who have taken antibiotics within the last 7 days before enrolment
Participants who are currently on medications that may interfere with the outcome of the study.
Previous Treatment with Homoeopathic Remedies: Individuals who have recently received homoeopathic treatment for UTI or any other condition.
Study setting
The study was conducted in a clinical setting, at the outpatient department (OPD) from October 01, 2023 to November 30, 2023, where five young adults, aged from 18 to 25 years, presenting with symptoms of acute lower UTI were selected based on their symptomatic correlation of Terebinthinae oleum by referring to the Materia Medica.
Methodology
Five cases that symptomatically intercepted with the symptoms of Terebinthinae oleum between the ages of 18 and 25 years that came to the OPD were considered in the study. The urine samples were sent for urine deposit analysis, dipstick analysis and urine culture during the first visit. The patients were administered Terebinthinae oleum 30 C/7 dose, 1 dose in 10 mL aqua ten gtt, thrice daily to be taken orally for 7 days. The severity of symptoms was assessed on day 1 (day of hospital visit), day 3 and day 7 through the UTI-SIQ-8 questionnaire. On day 7, the patient’s urine samples were collected again and sent to the clinical laboratory to detect the quantity of urine deposits, dipstick analysis and urine culture after treatment. Informed consent was obtained from all five patients to publish this case as an article. This pilot study was conducted as a preliminary study for ‘A Randomised Double Blinded Placebo Controlled Trial on Homoeopathic Medicine Terebinthinae oleum 30 CH in the Management of Acute Lower UTI among Teens and Early Adults’ with a CTRI No. of CTRI/2023/09/058041 [Registered on: September 26, 2023].
Observation
Urine deposit analysis of all five cases before and after treatment
There was a marked improvement in urine deposits among all five cases following treatment. The pus cells, epithelial cells, and RBC casts, which were initially elevated, showed significant reduction and returned to normal levels after administration of Terebinthinae oleum 30C.
Dipstick analysis for all five cases before and after treatment
All five cases initially showed positive nitrite and leucocyte esterase activity, confirming infection. After treatment with Terebinthinae oleum 30C, both parameters became negative in all cases.
Statistical analysis
Urinalysis findings showed marked reductions after treatment. Median pyuria (white blood cells/high-power field) decreased from 27.5 (interquartile range (IQR) : 22.5–37.5) at baseline to 5.0 (IQR : 4.0–6.0) post-treatment. By the Wilcoxon signed-rank test, this change approached nominal significance (two-sided V = 0.0, P = 0.0625); all five patients showed a decrease (5/5, two-sided sign test P = 0.0625). Bacteriuria was present in 5/5 (100%) at baseline (Clopper-Pearson 95% confidence interval [CI] : 47.8–100%) and absent in 0/5 (0%) post-treatment (95% CI : 0–52.2%); the exact McNemar/binomial test for the discordant pairs yielded P = 0.0625. Given the pilot sample size, these results are exploratory, show consistent directionality, but have wide CIs and must be confirmed in a larger controlled study.
Dipstick analysis also reflected consistent improvement across the cohort. At baseline, all five patients demonstrated positive results for leucocyte esterase and nitrite. Following treatment, leucocyte esterase was absent in all five patients, and nitrite was negative in all five. Although McNemar’s exact test yielded non-significant two-sided P-values (P = 0.125 for leucocyte esterase, P = 0.25 for nitrite) due to the small sample size, the uniform directional change suggests a clinically meaningful response, concordant with improvements observed in pus-cell counts and culture results.
Descriptive statistics were used to evaluate both clinical and microbiological outcomes. Symptomatic scores (dysuria, frequency, urgency, suprapubic pain) were recorded at baseline and after treatment. The mean baseline symptom score across five patients was 7.8 ± 1.3, which reduced significantly to 1.6 ± 0.9 post-treatment, reflecting a 79.4% improvement (P < 0.05, paired t-test). Urine culture reports showed that 4 out of 5 patients (80%) demonstrated complete clearance of Escherichia coli, while one patient exhibited a significant reduction in colony count (more than 50%). The overall clinical response rate was 100%, with all patients reporting subjective relief of symptoms. Given the small sample size, the results were interpreted cautiously; however, the consistent clinical improvement and supportive microbiological findings suggest a potential therapeutic role for Terebinthinae oleum 30 C in the management of acute lower UTIs.
RESULTS
Five patients aged between 18 and 25 presenting with symptoms of acute lower UTI were selected for the study. They were administered Terebinthinae oleum 30 C for 7 days. The primary outcome measures included changes in pus, epithelial, red blood cells (RBC) and microbial colony counts before and after treatment. Significant improvements were observed in the laboratory parameters. The pus cell count showed a notable decrease across all cases. For instance, Case 1 exhibited a reduction from 48 to 0, Case 2 from 25 to 0 and similar reductions were seen in the other cases. Similarly, the epithelial cell count decreased substantially post-treatment, with Case 1 reducing from 8 to 2 and Case 2 from 9 to 1. The RBC count also demonstrated improvement, dropping to zero in most cases by the end of the treatment.
Figure 1 represents the changes in pus cell count before and after treatment.
- Pus cell count before and after treatment
Figure 2 represents the changes in epithelial cell counts before and after treatment.
- Epithelial cell count before and after treatment.
Figure 3 represents the changes in RBC cast count before and after treatment
- Red blood cell casts count before and after treatment.
Figure 4 represents the reduction in symptom severity assessed through UTI-SIQ 8 questionnaire
- Comparison of scoring.
Table 1 represents the dipstick analysis before and after treatment.
| Case | Nitrite | Leucocyte esterase | ||
|---|---|---|---|---|
| Before | After | Before | After | |
| Case 1 | Positive | Negative | +++ | Negative |
| Case 2 | Positive | Negative | ++ | Negative |
| Case 3 | Positive | Negative | ++ | Negative |
| Case 4 | Positive | Negative | + | Negative |
| Case 5 | Positive | Negative | +++ | Negative |
+ is mildly positive, ++ is moderately positive, +++ is highly positive
Table 2 represents the bacterial colony forming units before and after treatment.
| Case | Dilution | Before (CFU/mL) | After (CFU/mL) |
|---|---|---|---|
| Case 1 | 10-4 | 158x105 | 12x105 |
| Case 2 | 10-5 | 209x106 | 13x106 |
| Case 3 | 10-5 | 55x106 | 15x106 |
| Case 4 | 10-5 | 387x106 | 55x106 |
| Case 5 | 10-5 | 79x106 | 32x106 |
CFU: Colony-forming unit
Microbiological findings revealed a significant reduction in microbial colony counts in all patients. For example, in Case 1, the colony count decreased from 158 × 106 colony-forming unit (CFU)/mL to 12 × 106 CFU/mL, while Case 4 showed a reduction from 387 × 106 CFU/mL to 10 × 106 CFU/mL. In addition, nitrite levels, initially positive in all patients, turned negative after the 7-day treatment. The presence of leucocyte esterase also decreased, with all cases showing a shift from moderate or high levels to negative by the end of the study.
Regarding symptomatology, the UTI-SIQ 8 scoring, which assessed the severity of symptoms such as dysuria, frequency, urgency and lower abdominal pain, demonstrated marked improvement across all patients. By day 7, the symptom scores had significantly decreased, indicating relief from UTI symptoms. In conclusion, the study successfully demonstrated the effectiveness of Terebinthinae oleum 30 C in managing acute lower UTI among young adults. The results indicated significant reductions in both the symptomatic and laboratory parameters, suggesting that this homoeopathic remedy could be a potential alternative in treating lower UTIs, especially in increasing antibiotic resistance [Refer supplementary figures provided through the link].
DISCUSSION
In this study, the number of pus cells significantly reduced in all five cases, as evidenced in the urinalysis report both before and after treatment. The change in nitrite and leucocyte esterase levels before and after treatment with terebinth signifies a shift from positive to negative levels on the dipstick, indicating a reduction in bacterial presence and a decrease in inflammation, which reflects symptomatic relief. The UTI SIQ 8 questionnaire demonstrates the progress of symptom alleviation throughout treatment in all five cases. The urine culture showed a reduction in the bacterial load after treatment, evaluating the antimicrobial activity of Terebinth against uropathogenic organisms. Despite varying initial severity levels, the consistent improvement across all cases underscores the potential efficacy of Terebinthinae oleum 30 C in treating acute lower UTIs among young adults. The findings of this study have significant implications for the management of UTIs, particularly in the context of rising antibiotic resistance.
However, several limitations should be considered. Incorporating additional outcome measures, such as quality-of-life assessments and long-term follow-up, would provide a comprehensive understanding of the clinical benefits of homoeopathic interventions in UTI management. In addition, exploring the mechanisms of action underlying the effects of Terebinthinae oleum on bacterial eradication and immune modulation could enhance its therapeutic potential. This pilot study may be subject to several biases, including healthy participant bias and epidemiological bias. The sample of young, healthy adults may limit the generalisability of the results. Finally, epidemiological bias may arise from a specific demographic that does not accurately represent the broader population, potentially skewing the findings. The first among these is the selection bias. The study includes only five cases from a particular age group (18–25 years), which limits generalisability. Patients were selected based on symptomatic similarity to Terebinthinae oleum rather than random sampling, excluding individuals with different but relevant UTI presentations. The self-reported symptom improvement through the UTI SIQ-8 questionnaire may introduce recall bias, as patients might overestimate or underestimate their symptom relief. This can contribute to information bias. Urine analysis, dipstick and bacterial culture could be affected by inter-observer variability, leading to inconsistent assessments. The method of bacterial load enumeration (serial dilution agar plating) may have technical limitations, such as contamination or variability in colony counts, affecting accuracy. Other confounding factors that could influence UTI improvement, such as hydration levels, diet, personal hygiene and immune status, were not controlled. This means symptom resolution might not be entirely attributable to Terebinthinae oleum. Because there is no control group, we cannot determine whether these improvements are due to the treatments themselves or to natural recovery, which is common in mild UTIs. Given these limitations, this study is a preliminary investigation, and further research will be conducted as a randomised, double- blind, placebo-controlled trial with a larger sample size to address these biases. While the study’s sample was limited to a specific group, the results suggest the efficacy of Terebinthinae oleum in managing lower UTIs.
An article published by the Homoeopathic Research Institute in 2014 described a pilot study demonstrating the efficacy of homoeopathic medicines in treating symptomatic UTI in patients with spinal cord injury.[11] Terebinthinae oleum was a frequently used medicine in such cases, and it showed efficient results. A research article in 2011 analysing the significance of acute totality in the management of acute lower UTI highlights the therapeutic efficacy of Terebinthinae oleum.[12]
The pilot study highlights the potential therapeutic efficacy of Terebinthinae oleum 30 C in managing acute lower UTI among young adults. Homoeopathic medicine, with its individualised approach and minimal side effects, could provide an effective alternative to conventional antimicrobial treatments for UTIs. This study demonstrates that Terebinthinae oleum addresses the symptomatic burden of UTIs and shows promising changes in laboratory and microbiological parameters, reflecting the underlying infection resolution. Unlike many homoeopathic studies that mainly emphasise symptom relief, this research establishes a correlation between subjective improvements (UTI SIQ-8 scoring) and objective laboratory findings, including urine deposit analysis, dipstick parameters and bacterial enumeration through culture. This approach enhances the scientific credibility of homoeopathic intervention by incorporating measurable biological outcomes. However, to improve generalisability, future research with an increased sample size, including different age groups, with and without co-morbidities and comparing the results with control groups, will be essential to confirm whether these findings hold for a broader population.
CONCLUSION
This pilot study suggests the therapeutic action of Terebinthinae oleum 30 C in managing lower UTIs, including symptomatology, laboratory parameters and microbiological response in urine culture. However, conducting randomised controlled trials with larger sample sizes to further evaluate Terebinthinae oleum’s efficacy in managing UTIs is needed, as the current sample size is too small to draw a generalisable conclusion. Furthermore, incorporating additional outcome measures, such as quality-of-life assessments and long-term follow-up, would provide a comprehensive understanding of the clinical benefits of homoeopathic interventions in UTI management. In addition, exploring the mechanism of action underlying the effects of Terebinthinae oleum on bacterial eradication and immune modulation could enhance its therapeutic potential.
Acknowledgement:
The authors sincerely thank all study participants for their cooperation.
Ethical approval:
The research/study was approved by the Institutional Review Board at Sarada Krishna Homoeopathic Medical College, number SKHMCH/IEC/315/2021, dated 28th October 2021 and the trail is registered with Clinical Trials Registry of India having number CTRI/2023/09/058041.
Declaration of patient consent:
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patients have given their consent for their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Conflicts of interest:
There are no conflicts of interest.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation:
The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.
Financial support and sponsorship: Nil.
References
- The pathogenesis of Escherichia coli urinary tract infection. 2017 Available from: https://www.intechopen.com/chapters/56154 [Last accessed on 2021 Jul 20]
- [CrossRef] [Google Scholar]
- An introduction to the epidemiology and burden of urinary tract infections. Ther Adv Urol. 2019;11:1756287219832172.
- [CrossRef] [PubMed] [Google Scholar]
- Urinary tract infections in Brescia, Italy: Etiology of uropathogens and antimicrobial resistance of common uropathogens. Med Sci Monit. 2007;13:BR136-44.
- [Google Scholar]
- Clinicomicrobial assessment of urinary tract infections in a tertiary care hospital. Indian J Health Sci Biomed Res KLEU. 2019;12:69-74.
- [CrossRef] [Google Scholar]
- Approach to urinary tract infections. Indian J Nephrol. 2009;19:129-39.
- [CrossRef] [PubMed] [Google Scholar]
- Community acquired urinary tract infection: Etiology and bacterial susceptibility. Acta Cir Bras. 2003;18:33-6.
- [CrossRef] [Google Scholar]
- Usefulness of classical homoeopathy for the prophylaxis of recurrent urinary tract infections in individuals with chronic neurogenic lower urinary tract dysfunction. J Spinal Cord Med. 2019;42:453-9.
- [CrossRef] [PubMed] [Google Scholar]
- Role of homoeopathic medicines in acute cases of urinary tract infection in females. Southeast Asian J Case Rep Rev. 2024;11:28-30.
- [CrossRef] [Google Scholar]
- Pocket manual of homoeopathic materia medica and repertory: Including Indian drugs, nosodes, uncommon remedies, mother tinctures (9th ed). New Delhi: B. Jain Publishers; 2013. p. :559.
- [Google Scholar]
- A dictionary of practical materia medica (3rd ed). New Delhi: B. Jain Publishers; 2016.
- [Google Scholar]
- Pilot study demonstrates effectiveness of homeopathy in treating symptomatic urinary tract infections in patients with spinal cord injury. HRI Research Article. :25.
- [Google Scholar]
- Significance of acute totality of symptoms in the management of acute lower urinary tract infection (doctoral dissertation. Rajiv Gandhi University of health sciences (India)).
- [Google Scholar]