Cranberries for preventing urinary tract infections

Abstract

BACKGROUND: Cranberries have been used widely for several decades for the prevention and treatment of urinary tract infections (UTIs). This is the third update of our review first published in 1998 and updated in 2004 and 2008. OBJECTIVES: To assess the effectiveness of cranberry products in preventing UTIs in susceptible populations. METHODS:Search methods: We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL in The Cochrane Library) and the Internet. We contacted companies involved with the promotion and distribution of cranberry preparations and checked reference lists of review articles and relevant studies. Date of search: July 2012. Selection criteria: All randomised controlled trials (RCTs) or quasi-RCTs of cranberry products for the prevention of UTIs. Data collection and analysis: Two authors independently assessed and extracted data. Information was collected on methods, participants, interventions and outcomes (incidence of symptomatic UTIs, positive culture results, side effects, adherence to therapy). Risk ratios (RR) were calculated where appropriate, otherwise a narrative synthesis was undertaken. Quality was assessed using the Cochrane risk of bias assessment tool. MAIN RESULTS: This updated review includes a total of 24 studies (six cross-over studies, 11 parallel group studies with two arms; five with three arms, and two studies with a factorial design) with a total of 4473 participants. Ten studies were included in the 2008 update, and 14 studies have been added to this update. Thirteen studies (2380 participants) evaluated only cranberry juice/concentrate; nine studies (1032 participants) evaluated only cranberry tablets/capsules; one study compared cranberry juice and tablets; and one study compared cranberry capsules and tablets. The comparison/control arms were placebo, no treatment, water, methenamine hippurate, antibiotics, or lactobacillus. Eleven studies were not included in the meta-analyses because either the design was a cross-over study and data were not reported separately for the first phase, or there was a lack of relevant data. Data included in the meta-analyses showed that, compared with placebo, water or not treatment, cranberry products did not significantly reduce the occurrence of symptomatic UTI overall (RR 0.86, 95% CI 0.71 to 1.04) or for any the subgroups: women with recurrent UTIs (RR 0.74, 95% CI 0.42 to 1.31); older people (RR 0.75, 95% CI 0.39 to 1.44); pregnant women (RR 1.04, 95% CI 0.97 to 1.17); children with recurrent UTI (RR 0.48, 95% CI 0.19 to 1.22); cancer patients (RR 1.15 95% CI 0.75 to 1.77); or people with neuropathic bladder or spinal injury (RR 0.95, 95% CI: 0.75 to 1.20). Overall heterogeneity was moderate (I² = 55%). The effectiveness of cranberry was not significantly different to antibiotics for women (RR 1.31, 95% CI 0.85, 2.02) and children (RR 0.69 95% CI 0.32 to 1.51). There was no significant difference between gastrointestinal adverse effects from cranberry product compared to those of placebo/no treatmen...

Exploring the gap: attitudes, knowledge, and training needs in complementary and integrative medicine among healthcare professionals at German university hospitals

“…In a survey among university hospital patients in Germany by Lederer et al, exercise, herbal medication, and dietary supplements were the three most used CIM methods ( 15 ). The effectiveness of some phytotherapeutic approaches has been demonstrated in several randomized controlled trials (e.g., turmeric in patients with irritable bowel syndrome ( 48 )) and systematic reviews (e.g., cranberries for prevention of urinary infections ( 7 ), St. John’s wort for moderate depression ( 49 ), and psyllium for chronic constipation ( 9 )). In our study, HCPs did not highlight phytotherapy as useful.…”

“…Complementary and integrative medical (CIM) approaches encompass a wide range of methods including nutritional, psychological, and physical approaches ( 1 ). While some CIM approaches are recommended in guidelines for health care professionals (HCPs) ( 2 ) and show positive results in studies, such as acupuncture ( 3–5 ) or relaxation therapy ( 6 ) to reduce pain or phytotherapy to prevent urinary infections ( 7 ) or cognitive impairment ( 8 ) or to reduce chronic constipation ( 9 ), others may cause interactions with conventional drugs, such as chemotherapy, and be potentially harmful for patients’ health, such as certain vitamins ( 10 ) or diets ( 11 ). Also, financial risks due to high costs are possible ( 12 ).…”

Recurrent Urinary Tract Infection in Older Outpatient Women

“…Cranberry products are reported to reduce rUTI risk by 26% among women of all ages . However, no single cranberry regimen is known to be superior to any other, and a subgroup analysis of more than 1400 older adults in long-term care facilities found no benefit of cranberry supplementation . Nonprescription supplements, such as d -mannose or Lactobacillus probiotics, have not yet been proven effective in rigorous trials.…”

The Effects of Cranberry Consumption on Glycemic and Lipid Profiles in Humans: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…These bioactive compounds have garnered considerable interest from researchers and have been extensively studied in recent years due to their various health benefits. The role of cranberry in preventing urinary tract infections in both adults and children has been widely acknowledged [ 3 ]. Some researchers now believe that cranberry can protect against cardiovascular diseases, reduce the risk of various cancers and metabolic diseases, and even prevent tooth decay, periodontitis, and Helicobacter pylori [ 2 , 4 , 5 ].…”