A Multicenter, Randomized, Placebo-Controlled Study Evaluating the Efficacy of a Combination of Propolis and Cranberry (<b><i>Vaccinium macrocarpon</i></b>) (DUAB®) in Preventing Low Urinary Tract Infection Recurrence in Women Complaining of Recurrent Cystitis

Abstract

&lt;b&gt;&lt;i&gt;Objectives:&lt;/i&gt;&lt;/b&gt; The purpose of the study was to compare the efficacy of a product containing cranberry and propolis (DUAB) to placebo for reducing frequency of cystitis in women with recurrent acute cystitis. &lt;b&gt;&lt;i&gt;Method:&lt;/i&gt;&lt;/b&gt; A multicenter, placebo-controlled, randomized study of women aged &amp;#x3e;18 years with at least 4 episodes of cystitis in the previous 12 months was performed. The number of cystitis episodes over a 6-month follow-up was the primary end point. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; Forty-two women were included in the cranberry + propolis group, and 43 women were in the placebo group. The mean age was 53 ± 18 years, with 6.2 ± 3.6 cystitis episodes in the previous year, with no differences between the 2 groups. The mean number of infections was lower in the propolis + cranberry group (respectively, 2.3 ± 1.8 vs. 3.1 ± 1.8). The total number of cystitis episodes in the first 3 months was lower in the propolis + cranberry group (0.7 ± 1.1 vs. 1.3 ± 1.1, &lt;i&gt;p&lt;/i&gt; = 0.0257) after adjusting for water consumption. The mean time to onset of the first urinary tract infection (UTI) was also significantly longer in the propolis + cranberry group (69.9 ± 45.8 days vs. 43.3 ± 45.9, &lt;i&gt;p&lt;/i&gt; = 0.0258). Tolerance to the treatments was good and comparable in both groups. &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; We demonstrate for the first time that cranberry and propolis supplementation significantly reduces the incidence of UTIs during the first 3 months and delays the onset of an episode of cystitis.

Alternative Therapeutic Options to Antibiotics for the Treatment of Urinary Tract Infections

“…A recent RCT versus placebo in 85 women with recurrent UTIs showed a slight reduction in the number of cystitis events in the first 3 months in the propolis and cranberry group after adjustment on water consumption (0.7 vs. 1.3, p = 0.02), but no difference in the mean number of infections in women with at least one infection. Of note, the mean time to onset of the first cystitis episode was significantly longer in the propolis + cranberry group (70 vs. 43 days, p = 0.03) and tolerance to the treatment was similar in both groups (Bruyère et al, 2019).…”

“…Cranberry (Ahuja et al, 1998;Howell et al, 2005;Freitas et al, 2006;Liu et al, 2006Liu et al, , 2019AFSSA, 2007;Jepson and Craig, 2008;Pereira et al, 2011;Ermel et al, 2012;Jepson et al, 2012;Stapleton et al, 2012;Chan et al, 2013;Boonsai et al, 2014;Olczyk et al, 2014;Ulrey et al, 2014;Rafsanjany et al, 2015;Rodríguez-Pérez et al, 2016;Wojnicz et al, 2016;Pasupuleti et al, 2017;Ranfaing et al, 2018a,b;Anger et al, 2019;Bruyère et al, 2019) • Reduction of adhesion, motility, and biofilm formation…”

The Results Given in the Paper by Bruyère et al. “Multicenter, Randomized, Placebo-Controlled Study [of] the Efficacy of a Combination of Propolis and Cranberry… (DUAB®) in Preventing Low Urinary Tract Infection Recurrence in Women… [with] Recurrent Cystitis” Should Be Used with Great Caution

“…We feel compelled to challenge the paper by Bruyère et al [1] entitled "A Multicenter, Randomized, Placebo-Controlled Study Evaluating the Efficacy of a Combination of Propolis and Cranberry (Vaccinium macrocarpon) (DUAB ® ) in Preventing Low Urinary Tract Infection Recurrence in Women Complaining of Recurrent Cystitis" (hereunder labelled "index study"), which has been published recently in the journal Urologia Internationalis.…”

Alternative Management of Uncomplicated UTIs in Women

“…Anti-biofilm effect of cranberry juice with natural borne antimicrobials derived from coconut oil (caprylic acid) and oregano essential oil (thymol) could synergistically enhance its eradicating activity against E. coli biofilms [53]. Bruyère et al [54] demonstrated for the first time that cranberry and propolis supplementation significantly reduces the incidence of UTIs during the first 3 months and delays the onset of an episode of cystitis. Tribulus terrestris induces its effect in fer-tility, sexual functions and southerner through the steroidal saponins, particularly the dominant saponins protodioscin [55].…”