Cranberry is not effective for the prevention or treatment of urinary tract infections in individuals with spinal cord injury

Department of Family Relations and Applied Human Nutrition, University of Guelph, Guelph, Ontario, Canada.
Spinal Cord (Impact Factor: 1.8). 11/2009; 48(6):451-6. DOI: 10.1038/sc.2009.159
Source: PubMed


Literature review.
Urinary tract infections (UTIs) are the most common medical complication experienced by individuals with spinal cord injury (SCI). Recent research presents conflicting evidence regarding use of cranberry in reducing growth and colonization of uroepithelial cells by uropathogenic bacteria. The objective was to determine whether the literature supports the use of cranberry in preventing or treating UTIs in the SCI population.
MEDLINE was searched for intervention studies, which investigated the use of cranberry in the prevention or treatment of UTIs in the SCI population. If the studies met the inclusion criteria, full articles were located and reviewed.
Five studies (four randomized clinical control-three trials using cranberry tablets vs placebos and one using cranberry juice-and one pilot study using cranberry juice) were identified which evaluated the effectiveness of cranberry products for the prevention or treatment of UTIs in the SCI population. Three studies reported no statistically significant effect of cranberry tablets in urinary pH, urinary bacterial count, urinary white blood cell (WBC) count, urinary bacterial, and WBC counts in combination or episodes of symptomatic UTIs. A fourth study showed that cranberry juice intake significantly reduced biofilm load compared with baseline. A final study reported fewer UTIs during the period with cranberry extract tablets vs placebo.
Limited evidence from clinical trials that vary in design suggests that cranberry, in juice or supplement form, does not seem to be effective in preventing or treating UTIs in the SCI population. More rigorous clinical research is needed to confirm this.

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    • "There was no significant influence of impairment on NS use however, 9% of athletes with a SCI reported the use of cranberry supplements which is likely due to the perceived prevention of urinary tract infections (UTIs) which are common in this population (Dermen et al., 2014). The limited evidence available, however, shows that cranberry supplements are ineffective at preventing and/or treating UTIs (Opperman, 2010). It is well-documented that AB athletes report the use of more NS than the general population (Erdman et al., 2006, Sobal & Marquart, 1994). "
    [Show abstract] [Hide abstract] ABSTRACT: The consumption of nutritional supplements (NS) is common among able-bodied (AB) athletes yet little is known about NS use by athletes with an impairment. This study examined the: (i) prevalence of NS use by athletes with an impairment; (ii) reasons for use/ non-use; (iii) sources of information regarding NS; and (iv) whether age, gender, impairment, performance level and sport category influence NS use. The questionnaire was completed by 399 elite (n=255) and non-elite (n=144) athletes (296 M, 103 F) online or at a sporting event/training camp. Data were evaluated using chi-square analyses. Fifty-eight percent (n=232) of athletes used NS in the previous 6-month period and 41% (n=102) of these followed the instructions on the label to determine dose. Adherence to these AB recommendations may partly explain why 9% (n=37) experienced negative effects from NS use. As expected, the most popular NS were: protein, sports drinks, multivitamins and carbohydrate supplements, which were obtained from health food/sport shops, internet and supermarkets (top 3) where evidence-based, impairment-specific advice is limited. The nutritionist/dietitian was the most used and trusted source of information, which is a promising finding. The most prevalent reasons for use were to support exercise recovery, support the immune system and provide energy. Elite athletes were more likely to use NS, which may reflect greater training hours and/or access to nutritionists. Fifty-two percent of athletes (n=209) requested more information/ education regarding NS. NS use is prevalent in this population. Education on dosage and appropriate sources of information is required.
    No preview · Article · Mar 2015 · International Journal of Sport Nutrition and Exercise Metabolism
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    • "Only one study reported fewer (reduced to 0.3 UTI per year versus 1 UTI per year while receiving placebo) UTIs during the period with cranberry extract tablets versus placebo. He concluded that cranberry, in juice or supplements form, does not seem to be effective in preventing or treating UTI in the SCI population [13]. In a multicenter survey published in 2005, 169 spina bifida clinics in the US were sent a questionnaire. "
    [Show abstract] [Hide abstract] ABSTRACT: Objectives. The aim of this randomized controlled prospective study is to evaluate the efficacy of cranberry capsules for prevention of UTI in children with neurogenic bladder caused by myelomeningocele. Patients and Methods. To be eligible for this study, patients had to be diagnosed as neurogenic bladder caused by myelomeningocele, evaluated urodynamically, followed up with clean intermittent catheterization and anticholinergic drugs. Intervention. Six months of treatment with placebo; after a week of wash-out period treatment of cranberry extract tablets (1 capsule/day) for an additional 6 months. Randomization was performed sequentially. Patients and care givers were blinded to drug assignment. Main outcome measure was infection rate. Group comparisons were performed with Wilcoxon test. Results. The study population included 20 (F/M: 13/7) patients with neurogenic bladder with the mean age of 7.25 ± 3.49 (4, 18) years. The median UTI rate was 0.5/year during placebo usage whereas 0/year during cranberry capsule usage. Decrease in infection rate was significant with cranberry capsule usage (P = 0.012). Decrease in the percentage of the pyuria was also recorded as significant (P = 0.000). Any adverse events or side effects were not recorded. Conclusion. We concluded that cranberry capsules could be an encouraging option for the prevention of recurrent UTI in children with neurogenic bladder caused by myelomeningocele.
    Full-text · Article · Jul 2012
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    • "There is currently insufficient evidence to support the administration of other adjunctive therapies to prevent recurrent infections. Although there is some evidence for a benefit of nutritional supplements (e.g., cranberry juice extract) for this indication in humans, the evidence is not strong and some studies have shown no effect10111213. Currently, there are no data to support the benefits of these measures in veterinary medicine. When effective in people, dietary supplements may help to prevent but not treat UTIs. "
    [Show abstract] [Hide abstract] ABSTRACT: Urinary tract disease is a common reason for use (and likely misuse, improper use, and overuse) of antimicrobials in dogs and cats. There is a lack of comprehensive treatment guidelines such as those that are available for human medicine. Accordingly, guidelines for diagnosis and management of urinary tract infections were created by a Working Group of the International Society for Companion Animal Infectious Diseases. While objective data are currently limited, these guidelines provide information to assist in the diagnosis and management of upper and lower urinary tract infections in dogs and cats.
    Full-text · Article · Jun 2011 · Veterinary Medicine International
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