Does ingestion of cranberry juice reduce symptomatic urinary tract infections in older people in hospital? A double-blind, placebo-controlled trial

McMurdo, Marion E. T.; Bissett, Linda; Price, Rosemary J. G.; Phillips, G.; Crombie, Iain K.

doi:10.1093/ageing/afi101

Cited by 109 publications

(77 citation statements)

References 11 publications

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“…Two studies reported that cranberry juice may be protective in subgroups of older adults, 21,22 but the effectiveness of cranberry capsules in the protection against UTI in vulnerable older persons in LTCFs has not been studied.…”

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confidence: 99%

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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confidence: 99%

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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“…Several trials have indeed missed the calculated UTI recurrence rates necessary to show differences between groups. 49,51,52 In one trial not a single event occurred. 52 This problem should be overcome by recruiting patients with a true high recurrence risk indicated by a pattern of .5 UTI/year rather than on the basis of a recent UTI, as most trials up to now have done.…”

Section: The Mixed Evidence From Clinical Trialsmentioning

confidence: 99%

“…51,53,55,56 To give an example, only 21/376 (5.6%) of hospitalized patients (mean age 81.5 years) had a clinical UTI within a follow-up of 35 days and an intervention period of 18 days in the study by McMurdo et al 51 At that low event rate, the study time had been too short to find differences, which may well have become evident at a longer study duration. The risk of underdosing has led investigators to apply different doses of cranberry products 38,[57][58][59] or to simply administer the highest available cranberry dose.…”

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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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“…However, there is no sufficient clinical evidence that cranberry type-A proanthocyanidins are effective at lowering the risk of urinary tract infection (Guay 2009, Jepson et al 2012, Vasileiou et al 2013. Some authors did not show the effectiveness of cranberry used versus placebo (McMurdo et al 2005). Dugoua et al (2008) suggest that consumption of cranberry in pregnancy is safe but they also indicated that there is no direct evidence of safety or harm to the mother or fetus as a result of consuming cranberry during pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Morphometric abnormalities in spleen and kidney of the progeny of mice fed American cranberry extract (Vaccinium macrocarpon) during pregnancy and lactation

Bałan¹,

Lewicki²,

Siwicki³

et al. 2017

Polish Journal of Veterinary Sciences

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Cranberries and cranberry-derived diet supplements are often recommended for the treatment of urinary tract infections, also during pregnancy. These products contain strongly anti-angiogenic chemical compounds which could not be indifferent to the developing fetus. In the present work we evaluated the effect of feeding pregnant and lactating mice American cranberry extract (daily dose 0.88 mg) on the morphology and some parameters of spleen and kidney function of their adult progeny. Six weeks after delivery the morphometry of spleen and kidney, cytometric analysis of spleen lymphocytes, evaluation of humoral response to SRBC (Sheep Red Blood Cells), and examination of serum creatinine/urea concentration, were performed in the offspring. Spleens of progeny from experimental (E) group differed from the spleens of progeny of control mice in the lower number of lymphatic nodules and their larger diameter. Cytometry of spleen cells from progeny of E mothers revealed more CD19 + and CD8 + lymphocytes than in the control group. No difference was seen in the response to immunization by red blood cells of sheep (SRBC) between control and E offspring. An increase in the diameter of glomeruli was observed in the kidneys of the experimental group in comparison with the control group. No abnormalities in creatinine and urea serum level were observed. A higher concentration of VEGF and bFGF in E offspring sera in comparison to the controls was seen. Conclusion: Although the observed differences between the control and experimental group were not large, caution is recommended in using cranberries and their extracts during pregnancy until more research will be done on this topic.

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Does ingestion of cranberry juice reduce symptomatic urinary tract infections in older people in hospital? A double-blind, placebo-controlled trial

Cited by 109 publications

References 11 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

Morphometric abnormalities in spleen and kidney of the progeny of mice fed American cranberry extract (Vaccinium macrocarpon) during pregnancy and lactation

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