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...

Cranberry capsules to prevent nosocomial urinary tract bacteriuria after pelvic surgery: a randomised controlled trial

“…Our results are in line with a recent Cochrane review that did not find any significant decrease of recurrent UTIs with cranberries as compared with placebo or other forms of treatment . Also, the preventive effectiveness of cranberry was not significantly different from that of antibiotics.…”

Cranberry capsules to prevent nosocomial urinary tract bacteriuria after pelvic surgery: a randomised controlled trial

“…Our results are in line with a recent Cochrane review that did not find any significant decrease of recurrent UTIs with cranberries as compared with placebo or other forms of treatment . Also, the preventive effectiveness of cranberry was not significantly different from that of antibiotics.…”

Cranberries and Urinary Tract Infections in Women

“…Subgroup analysis demonstrated that cranberrycontaining products seemed to be more effective in women with rUTI (RR: 0.53; 95% CI: 0.33, 0.83), although the P values were not significant. These results were similar to the results of the review by Jepson and Craig [5].…”

Cranberry syrup vs trimethoprim in the prophylaxis of recurrent urinary tract infections among children: a controlled trial

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Cranberry capsules to prevent nosocomial urinary tract bacteriuria after pelvic surgery: a randomised controlled trial

“…Our results are in line with a recent Cochrane review that did not find any significant decrease of recurrent UTIs with cranberries as compared with placebo or other forms of treatment . Also, the preventive effectiveness of cranberry was not significantly different from that of antibiotics.…”

Cranberries and Urinary Tract Infections in Women

“…Subgroup analysis demonstrated that cranberrycontaining products seemed to be more effective in women with rUTI (RR: 0.53; 95% CI: 0.33, 0.83), although the P values were not significant. These results were similar to the results of the review by Jepson and Craig [5].…”

Cranberry syrup vs trimethoprim in the prophylaxis of recurrent urinary tract infections among children: a controlled trial

“……”

Cranberry capsules to prevent nosocomial urinary tract bacteriuria after pelvic surgery: a randomised controlled trial

“…Our results are in line with a recent Cochrane review that did not find any significant decrease of recurrent UTIs with cranberries as compared with placebo or other forms of treatment . Also, the preventive effectiveness of cranberry was not significantly different from that of antibiotics.…”

Cranberries and Urinary Tract Infections in Women

“…Subgroup analysis demonstrated that cranberrycontaining products seemed to be more effective in women with rUTI (RR: 0.53; 95% CI: 0.33, 0.83), although the P values were not significant. These results were similar to the results of the review by Jepson and Craig [5].…”

Cranberry syrup vs trimethoprim in the prophylaxis of recurrent urinary tract infections among children: a controlled trial

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