Cranberry-Containing Products for Prevention of Urinary Tract Infections in Susceptible Populations

Wang, Chih‐Hung; Fang, Cheng-Chung; Chen, N. C.; Liu, Shih-Hung; Yu, Ping‐Hsun; Wu, Tao-Yu; Chen, Wei‐Ting; Lee, Chien‐Chang; Chen, Shyr‐Chyr

doi:10.1001/archinternmed.2012.3004

Cited by 213 publications

(158 citation statements)

References 24 publications

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“…19 A Cochrane review reported a UTI reduction of 35% (95% CI = 10-54%). 17 In the recent update of this Cochrane review in 2012, the authors performed a meta-analysis based on two studies evaluating cranberry in elderly adults (N = 413).…”

Section: Effectivenessmentioning

confidence: 99%

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Effectiveness of cranberry capsules to prevent urinary tract infections in vulnerable older persons. A double-blind randomized placebo-controlled trial in long-term care facilities

Caljouw¹,

Hout²,

Putter³

et al. 2013

European Geriatric Medicine

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OBJECTIVES:To determine whether cranberry capsules prevent urinary tract infection (UTI) in long-term care facility (LTCF) residents. DESIGN: Double-blind randomized placebo-controlled multicenter trial. SETTING: Long-term care facilities (LTCFs). PARTICIPANTS: LTCF residents (N = 928; 703 women, median age 84). MEASUREMENTS: Cranberry and placebo capsules were taken twice daily for 12 months. Participants were stratified according to UTI risk (risk factors included long-term catheterization, diabetes mellitus, ≥1 UTI in preceding year). Main outcomes were incidence of UTI according to a clinical definition and a strict definition. RESULTS: In participants with high UTI risk at baseline (n = 516), the incidence of clinically defined UTI was lower with cranberry capsules than with placebo (62.8 vs 84.8 per 100 person-years at risk, P = .04); the treatment effect was 0.74 (95% confidence interval (CI) = 0.57-0.97). For the strict definition, the treatment effect was 1.02 (95% CI = 0.68-1.55). No difference in UTI incidence between cranberry and placebo was found in participants with low UTI risk (n = 412). CONCLUSION: In LTCF residents with high UTI risk at baseline, taking cranberry capsules twice daily reduces the incidence of clinically defined UTI, although it does not reduce the incidence of strictly defined UTI. No difference in incidence of UTI was found in residents with low UTI risk. J Am Geriatr Soc 62:103-110, 2014.

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Section: Effectivenessmentioning

confidence: 99%

“…17,18 Another recent systematic review indicates that cranberry-containing products are associated with a protective effect against UTI in different subgroups, albeit with heterogeneity across the included trials. 19 A recent study in children without urological abnormalities showed a 65% reduction of UTI with the use of cranberry.…”

mentioning

confidence: 98%

Effectiveness of cranberry capsules to prevent urinary tract infections in vulnerable older persons. A double-blind randomized placebo-controlled trial in long-term care facilities

Caljouw¹,

Hout²,

Putter³

et al. 2013

European Geriatric Medicine

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“…The most recent two meta-analyses have come to different conclusions. While Jepson et al 47 in their Cochrane Review concluded that there was no evidence for cranberries to prevent UTI, Wang et al 48 found a weak evidence after having excluded one trial as a negative outlier. 49 However, critics rightly argued that this maneuver had caused a bias, as data from a positive outlier study had still been analyzed.…”

Section: The Mixed Evidence From Clinical Trialsmentioning

confidence: 99%

Cranberry products in the prevention of urinary tract infections: examining the evidence

Nowack¹,

Birck²

2015

BTAT

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Cranberry (Vaccinium macrocarpon) juice and extracts are widely used and recommended as folk remedy for prophylaxis of urinary tract infections (UTIs). Its putative mechanism is an anti-adhesive effect that prevents docking of bacteria on host tissues. The antiadhesion quality is attributed to A-type proanthocyanidins (PACs), a group of polyphenols that has a restricted occurrence in cranberries and a few related plants. Clinical trials with cranberry have provided a mixed evidence on behalf of UTI prophylaxis. In some trials, a benefit could not be detected due to lower than calculated UTI recurrence rates, in others failure had retrospectively been blamed on underdosing of cranberry products. To circumvent such problems, cranberry products need to be standardized for the bioactive principle of PAC and administered at a sufficient dose. Further characterization of PAC bioavailability, improvement of the currently inconvenient prescriptions, and above all of the palatability for patients is strongly recommended. Larger staged trials should then be carried out in patients with relevant UTI risks.

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“…Cranberry products (juice, tablets, capsules) have been used widely for the prevention and treatment of UTIs. 24,25 However, current evidence does not support their use and they are no longer recommended for the prevention of recurrent UTIs. 26 Oestrogen products (for postmenopausal women) and methenamine hippurate are also not recommended as there is no good evidence to support their use for preventing recurrent UTIs.…”

Section: Recurrent Bacterial Uti In Womenmentioning

confidence: 99%

Urinary tract infections: diagnosis and management

Durojaiye¹,

Healy²

2015

Prescriber

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Cranberry-Containing Products for Prevention of Urinary Tract Infections in Susceptible Populations

Abstract: Our findings indicate that cranberry-containing products are associated with protective effect against UTIs. However, this result should be interpreted in the context of substantial heterogeneity across trials.

Cited by 213 publications

References 24 publications

Effectiveness of cranberry capsules to prevent urinary tract infections in vulnerable older persons. A double-blind randomized placebo-controlled trial in long-term care facilities

Effectiveness of cranberry capsules to prevent urinary tract infections in vulnerable older persons. A double-blind randomized placebo-controlled trial in long-term care facilities

Cranberry products in the prevention of urinary tract infections: examining the evidence

Urinary tract infections: diagnosis and management

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