The study shows two antimicrobial peptides, FA‑LL‑37 and cecropin P1, can kill common urinary‑tract bacteria like E. coli, P. aeruginosa and K. pneumoniae at micromolar levels while mostly leaving beneficial lactobacilli untouched, suggesting they might be useful in a topical cream for UTIs, but the work is still early and no human dosing or safety info is provided.

Two mammalian antimicrobial peptides, FA-LL-37 and cecropin P1, were tested for activity against six uropathogens and five Lactobacillus strains by broth microdilution assay. Both peptides inhibited Escherichia coli at 25 microM (FA-LL-39), and 1.56 microM (cecropin P1), Pseudomonas aeruginosa (12.5 microM, and 25 microM), and Klebsiella pneumoniae, (50 microM, and 1.56 microM), but not Enterococcus faecalis and Staphylococcus epidermidis. FA-LL-37 acted bacteriocidally against E. coli and bacteriostatically against the other two Gram-negative organisms. Cecropin P1 was bacteriocidal to all susceptible bacteria. Lactobacilli were resistant to both peptides, with the exception of poultry isolate Lactobacillus fermentum B-54, which was susceptible to FA-LL-37 at 100 microM. The differential activities of these peptides toward Gram-negative uropathogens versus urogenital lactobacilli demonstrate their potential as a topical treatment for urinary tract infections. In addition, production of such peptides in vivo could be a natural mechanism to aid in the maintenance of the lactobacilli-dominated urogenital flora at the expense of pathogens.