The evolution of recommendations for cranberry use in recurrent urinary tract infections: A systematic review

N.I.  Carvalho; G.G.  Leite; B.B.  Silva; I.L.  Souza; L.D.  Souza; I.M. De  Faria

doi:10.31450/ukrjnd.1(73).2022.09

N.I. Carvalho Medical student at University José do Rosário Vellano https://orcid.org/0000-0003-4281-4355
G.G. Leite Medical students at University of Itaúna https://orcid.org/0000-0003-0731-9770
B.B. Silva Medical student at Pontifical Catholic University of Minas Gerais https://orcid.org/0000-0003-2390-2122
I.L. Souza Medical students at University of Itaúna https://orcid.org/0000-0002-6177-5059
L.D. Souza Medical students at University of Itaúna https://orcid.org/0000-0003-3598-5842
I.M. De Faria Chief of Gynecology and Obstetrics Department and Professor at University of Itaúna

DOI: https://doi.org/10.31450/ukrjnd.1(73).2022.09

Keywords: cranberry, prophylaxis, recommendations, urinary tract infection

Abstract

Abstract. Urinary tract infections (UTI) constitute a major complaint in medical offices worldwide, especially concerning women. Although the efficacy of cranberry in UTI prevention is still controversial it has long been recommended for use in clinical practice. Based on the recommendation evaluation, the present study aimed to conduct a systematic review to assess the efficacy of cranberry prophylaxis in recurrent UTIs in women. Main changes among reviewed publications revolved around the mechanism by which cranberry produce the results observed and once it was established that it relates to bacterial fimbriae-mediated adhesion, most authors now struggle to establish accurate measures to come up with a protocol for its use. Many studies compared cranberry effects to placebo and traditional antibiotic treatment and showed promising results about effectiveness, as well as economic drawbacks. Altogether, cranberries could help to delay ecological resistance to antibiotics as well as protect patients from infections. Further investigation, mainly regarding dosage, is needed to formulate protocols and safely introduce cranberries to clinical practice

Downloads

Download data is not yet available.

References

Quesada NV, Muñoz LS. Actividad antimicrobiana del arándano (Vaccinium macrocarpon). Rev médica Costa rica y Centroam. 2013;70:9-12. Available from: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=40645.

Valdevenito JP, Álvarez D. Infección urinaria recurrente en la mujer. Rev Médica Clínica Las Condes. 2018;29:222–31. doi:10.1016/j.rmclc.2018.02.010.

Valdevenito S JP. [Recurrent urinary tract infection in women]. Rev Chilena Infectol. 2008;25:268–76. http://dx.doi.org/10.4067/S0716-10182008000400004.

Dwyer PL, O’Reilly M. Recurrent urinary tract infection in the female. Curr Opin Obstet Gynecol. 2002;14:537–43. doi: 10.1097/00001703-200210000-00016.

Di Martino P, Agniel R, David K, Templer C, Gaillard JL, Denys P, et al. Reduction of Escherichia coli adherence to uroepithelial bladder cells after consumption of cranberry juice: a double-blind randomized placebo-controlled cross-over trial. World J Urol. 2006;24:21-7. doi:10.1007/s00345-005-0045-z.

DE Leo V, Cappelli V, Massaro MG, Tosti C, Morgante G. [Evaluation of the effects of a natural dietary supplement with cranberry, Noxamicina® and D-mannose in recurrent urinary infections in perimenopausal women]. Minerva Ginecol. 2017;69:336–41. doi:10.23736/S0026-4784.17.04074-6.

Cooper KL, Badalato GM, Rutman MP. Schaeffer AJ, Matulewicz RS, Klumpp DJ. Infections of the urinary tract. Campbell-Walsh Urol 12th ed Philadelphia, PA Elsevier. 2021.

Kraft JK, Stamey TA. The natural history of symptomatic recurrent bacteriuria in women. Medicine (Baltimore). 1977;56:55–60. Available from: https://pubmed.ncbi.nlm.nih.gov/319320/.

Burleigh AE, Benck SM, McAchran SE, Reed JD, Krueger CG, Hopkins WJ. Consumption of sweetened, dried cranberries may reduce urinary tract infection incidence in susceptible women – a modified observational study. Nutr J. 2013;12:139. doi:10.1186/1475-2891-12-139.

Letouzey V, Ulrich D, Demattei C, Alonso S, Huberlant S, Lavigne J-P, et al. Cranberry capsules to prevent nosocomial urinary tract bacteriuria after pelvic surgery: a randomised controlled trial. BJOG An Int J Obstet Gynaecol. 2017;124:912-7. doi:10.1111/1471-0528.14524.

Geerlings SE, Beerepoot MAJ, Prins JM. Prevention of Recurrent Urinary Tract Infections in Women. Infect Dis Clin North Am. 2014;28:135-47. doi:10.1016/j.idc.2013.10.001.

Foxman B. The epidemiology of urinary tract infection. Nat Rev Urol. 2010;7:653-60. doi:10.1038/nrurol.2010.190.

Murray BE, Rensimer ER, DuPont HL. Emergence of High-Level Trimethoprim Resistance in Fecal Escherichia coli during Oral Administration of Trimethoprim or Trimethoprim-Sulfamethoxazole. N Engl J Med. 1982;306:130-5. doi:10.1056/NEJM198201213060302.

Gupta K. Emerging antibiotic resistance in urinary tract pathogens. Infect Dis Clin North Am. 2003;17:243–59. doi:10.1016/S0891-5520(03)00006-0.

Asma B, Vicky L, Stephanie D, Yves D, Amy H, Sylvie D. Standardised high dose versus low dose cranberry Proanthocyanidin extracts for the prevention of recurrent urinary tract infection in healthy women [PACCANN]: a double blind randomised controlled trial protocol. BMC Urol. 2018;18:29. doi:10.1186/s12894-018-0342-7.

Barbosa-Cesnik C, Brown MB, Buxton M, Zhang L, Debusscher J, Foxman B. Cranberry juice fails to prevent recurrent urinary tract infection: Results from a randomized placebo-controlled trial. Clin Infect Dis. 2011;52:23-30. doi: 10.1093/cid/ciq073.

Hisano M, Bruschini H, Nicodemo A, Srougi M. Cranberries and lower urinary tract infection prevention. Clinics. 2012;67:661-7. doi:10.6061/clinics/2012(06)18.

Wojnicz D, Sycz Z, Walkowski S, Gabrielska J, Aleksandra W, Alicja K, et al. Study on the influence of cranberry extract Żuravit S·O·S® on the properties of uropathogenic Escherichia coli strains, their ability to form biofilm and its antioxidant properties. Phytomedicine. 2012;19:506–14. doi:10.1016/j.phymed.2011.12.013.

Fu Z, Liska D, Talan D, Chung M. Cranberry Reduces the Risk of Urinary Tract Infection Recurrence in Otherwise Healthy Women: A Systematic Review and Meta-Analysis. J Nutr. 2017;147:2282-8. doi:10.3945/jn.117.254961.

Blatherwick NR, Long ML. Studies of urinary acidity II. The increased acidity produced by eating prunes and cranberries. J Biol Chem. 1923;57:815-8.

Schultz A. Efficacy of Cranberry Juice and Asorbic Acid in Acidifying the Urine in Multiple Sclerosis Subjects. J Community Health Nurs. 1984;1:159-69. doi:10.1207/s15327655jchn0103_5.

Fellers CR, Redmon BC, Parrott EM. Effect of cranberries on urinary acidity and blood alkali reserve. J Nutr. 1933;6:455–63. Available from: https://www.cabdirect.org/cabdirect/abstract/19331403322.

Kinney AB, Blount M. Effect of cranberry juice on urinary pH. Nurs Res. 1979;28:287-90. Available from: http://www.ncbi.nlm.nih.gov/pubmed/38439.

McLeod DC, Nahata MC. Methenamine therapy and urine acidification with ascorbic acid and cranberry juice. Am J Hosp Pharm. 1978;35:654. Available from: https://pubmed.ncbi.nlm.nih.gov/27096/.

Nickey KE. Urinary ph-effect of prescribed regimes of cranberry juice and ascorbic-acid. In: Archives of Physical Medicine and Rehabilitation. WB Saunders Co Independence Square West Curtis Center, STE 300, Philadelphia; 1975. p. 556.

Jepson RG, Williams G, Craig JC. Cranberries for preventing urinary tract infections. Sao Paulo Med J. 2013;131:363–363. doi:10.1590/1516-3180.20131315T1.

Haverkorn MJ, Mandigers J. Reduction of bacteriuria and pyuria using cranberry juice. Jama. 1994;272:590. doi: 10.1001/jama.272.8.590a.

Emody L, Kerenyi M, Nagy G. Virulence factors of uropathogenic Escherichia coli. Int J Antimicrob Agents. 2003;22:29-33. doi: 10.1016/s0924-8579(03)00236-x.

Gupta K, Chou MY, Howell A, Wobbe C, Grady R, Stapleton AE. Cranberry products inhibit adherence of p-fimbriated Escherichia coli to primary cultured bladder and vaginal epithelial cells. J Urol. 2007;177:2357-60. doi: 10.1016/j.juro.2007.01.114.

Foo LY, Lu Y, Howell AB, Vorsa N. A-Type Proanthocyanidin Trimers from Cranberry that Inhibit Adherence of Uropathogenic P-Fimbriated Escherichia c oli. J Nat Prod. 2000;63:1225–8. doi:10.1021/np000128u.

Hassan MHA, Hassan A, Nursing G. Effect of intervention guidelines on self care practices of pregnant women with urinary tract infection. Life Sci J. 2015;12:113-24.

Stothers L. A randomized trial to evaluate effectiveness and cost effectiveness of naturopathic cranberry products as prophylaxis against urinary tract infection in women. Can J Urol. 2002;9:1558-62. Available from: https://pubmed.ncbi.nlm.nih.gov/12121581/.

Waites KB, Canupp KC, Armstrong S, DeVivo MJ. Effect of cranberry extract on bacteriuria and pyuria in persons with neurogenic bladder secondary to spinal cord injury. J Spinal Cord Med. 2004;27:35-40. doi: 10.1080/10790268.2004.11753728.

McMurdo MET, Bissett LY, Price RJG, Phillips G, Crombie IK. Does ingestion of cranberry juice reduce symptomatic urinary tract infections in older people in hospital? A double-blind, placebo-controlled trial. Age Ageing. 2005;34:256-61. doi: 10.1093/ageing/afi101.

Kontiokari T, et al. Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women. BMJ. 2001;322:1571. doi:10.1136/bmj.322.7302.1571.

Bailey DT, Dalton C, Daugherty FJ, Tempesta MS. Can a concentrated cranberry extract prevent recurrent urinary tract infections in women? A pilot study. Phytomedicine. 2007;14:237-41. doi: 10.1016/j.phymed.2007.01.004.

Hess MJ, Hess PE, Sullivan MR, Nee M, Yalla S V. Evaluation of cranberry tablets for the prevention of urinary tract infections in spinal cord injured patients with neurogenic bladder. Spinal Cord. 2008;46:622-6. doi: 10.1038/sc.2008.25.