cranberry juice uti evidence

Terms: (1) beverage, fruit beverage, fruit drink, fruit juice, cranberry, To assess the effectiveness of cranberry products in preventing UTIs in susceptible populations, RCTs and quasi-RCTs; comparison of cranberry products vs. placebo, no intervention, or other intervention; excluded studies on treatment of UTIs; excluded studies on UTIs not caused by bacterial infection; outcomes: incidence of UTIs, Cranberry juice is less effective than previously indicated; cranberry juice cannot currently be recommended for the prevention of UTIs. (20), Jepson and Craig (21), and Wang et al. Because the significance of RR estimates in the Kontiokari et al. Only 2 studies were included in all analyses (Table 2), with another 5 studies included in both the Jepson et al. These observations have indicated that cranberries may provide an option for prophylaxis in certain populations. Walker EB, Barney DP, Mickelsen JN, Walton RJ, Mickelsen RAJr. Augmentation with Atypical Antipsychotics for Treatment-Resistant Depression. Cranberry juice does not appear to have a significant benefit in preventing UTIs and may be unacceptable to consume in the long term. There also is a large body of clinical trial research in humans using a variety of cranberry products in different patient populations. (20) (RR: 0.86; 95% CI: 0.71, 1.04) was heavily influenced by results from studies in populations with complicated UTIs (cUTIs), particularly patients with neuropathic bladder, spinal cord injury, and radiotherapy. Cranberries (usually as cranberry juice) have been used to try and treat UTIs, particularly in high risk groups such as older people. Side effects were common, and losses to followup/withdrawals in several of the trials were high (> 40%). The discussion section in both systematic reviews explored potential reasons that findings by Barbosa-Cesnik et al. See specific reports for full list of search terms. Inconsistency in meta-analysis methodologies, including clinical (i.e., participants, outcome, and intervention) and methodological heterogeneity (i.e., trial design and execution including i… Cranberry products (such as tablets or capsules) were also ineffective (although had the same effect as taking antibiotics), possibly due to … Some studies have found that drinking cranberry juice or taking cranberry pills can prevent UTIs, especially in women who are at risk for these infections. A Systematic Review of Randomized Controlled Trials, Association of Total Nut, Tree Nut, Peanut, and Peanut Butter Consumption with Cancer Incidence and Mortality: A Comprehensive Systematic Review and Dose-Response Meta-Analysis of Observational Studies, Intake of Various Food Groups and Risk of Breast Cancer: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies, http://www.nutrition.org/publications/guidelines-and-policies/license/, Receive exclusive offers and updates from Oxford Academic. There is moderately-high level evidence that cranberry juice is ineffective in the prevention of UTIs in young sexually-active women, as compared to placebo juice. The 4 studies contributed the majority (53.7%) of total weight to the total RR estimate in Jepson et al., 2012 (20). Cranberries have historically been associated with urinary tract health, particularly among women with rUTIs (10–12). A literature search was conducted to identify eligible systematic reviews and meta-analyses to be included in this assessment (see Supplemental Data). 1 However, 2 recent randomized studies, not included in the Cochrane review, found that women taking cranberry juice have fewer symptomatic UTIs. Beerepoot MAJ, Geerlings SE, van Haarst EP, Mensing van Charante N, ter Riet G. Avorn J, Monane M, Gurwitz JH, Glynn RJ, Choodnovskiy I, Lipsitz LA. Traditionally, the cranberry has been used to prevent rUTIs among generally healthy women. A 2012 Cochrane review concludedthat there was no good evidence to suggest cranberries offer any meaningful benefits: Cranberries (usually as cranberry juice) have been used to prevent urinary tract infections (UTIs). Terms: (1) beverage, cranberry, fruit beverage, fruit drink, fruit juice, To assess the effectiveness of cranberry in preventing UTIs in susceptible populations. Among the generally healthy population, the risk of having an uncomplicated UTI is ∼50 times higher in adult women than in adult men (3). (47) as an outlier and excluded this study from the analysis on which their final conclusion was based. : CD001321. (19) report also addressed separate populations in their conclusions, noting that cranberry products appear to be more effective for prevention of rUTIs in women. Differences in subgroup contributions to overall relative risk estimates. Evidence summary. In addition, this review explores methodological differences that may be related to these conflicting findings. 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 is some evidence from four good quality RCTs that cranberry juice may decrease the number of symptomatic UTIs over a 12‐month period, particularly in women with recurrent UTIs. ... R., Chazan, B., and Dan, M. [Cranberry juice and urinary tract infection]. To present a broad overview of evidence on cranberry for the treatment of UTIs, and to summarize the evidence supporting its clinical use, The cranberry efficacy-to-safety ratio strongly supports its use in the prevention of rUTIs in young and middle-aged women; clinical use in other groups remains controversial, To evaluate the research literature in which cranberry-based products are used to prevent or treat UTIs, Published in English; RCTs, comparative studies, meta-analyses, controlled clinical trials; includes clinical outcomes; human females, Some evidence suggests that cranberry products, especially in juice or cocktail form, prevent infections in some preliminary studies, but available evidence is limited, Terms: (1) Vaccinium, cranberry, fruit beverage, fruit drink, fruit juice, beverage; (2) UTIs, cystitis, bacteriuria, pyelonephritis, urinary infection, or bacterial infection; databases: Medline, Embase, Cochrane Controlled Trials Registry, CENTRAL, and others, To assess the effectiveness of cranberry or blueberry products in the prevention of symptomatic UTIs in susceptible populations, RCTs and quasi-RCTs; cranberry products vs. placebo, no treatment or any other treatment; studies in men, women, and children susceptible to UTIs; outcome: incidence of UTIs, There is some evidence from 4 good quality RCTs that cranberry juice may decrease the number of symptomatic UTIs over a 12-mo period, particularly in women with rUTIs; it's uncertain whether cranberry is effective in other groups, Systematic review and cost-effectiveness analysis, Terms: (1) recurrent, urine or urinary; and (2) infectious or infection(s); databases: Medline, Embase, Cochrane Library, To compare the effectiveness, cost, and health-related quality-of-life outcomes associated with commonly used strategies for management of rUTIs, Published in English; comparative clinical trial; placebo/untreated control; human study; nonpregnant female adults with ≥3 UTIs/y; outcomes: incidence of UTI, Daily cranberry pills are effective at reducing UTIs and are cost effective; daily antibiotic use is more effective than cranberry pills, Terms: (1) prevention and control, prophylaxis; with (2) urinary tract infections, cystitis, pyelonephritis, UTI; databases: Medline, Embase, Cochrane Library, To assess the effectiveness, tolerability, and safety of nonantibiotic prophylaxis in adults with recurrent urinary tract infections, RCTs with parallel design; adults with recurrent UTIs; compared nonantibiotic prophylaxis to placebo or no treatment, Cranberry juice and tablets reduce the occurrence of UTIs vs. placebo, To evaluate cranberry-containing products for the prevention of UTIs, RCTs; compared cranberry products vs. placebo/control; outcome: incidence of UTIs, Cranberry-containing products are associated with protective effects against UTIs, July 2012; update of Cochrane 2008 review. Steel N, Abdelhamid A, Stokes T, Edwards H, Fleetcroft R, Howe A, Qureshi N. Supported by Ocean Spray Cranberries, Inc. Here’s where things get murky, though — like, blood-in-your-urine murky. Overall heterogeneity was moderate (I² = 55%). Although it is generally safe and there are theoretical reasons for a benefit, clinical studies have not definitively shown a reduction in UTIs. In this comparison, it was noted that different values were extracted from 1 of the studies that was included in Jepson et al. study (47). Lee BB, Haran MJ, Hunt LM, Simpson JM, Marial O, Rutkowski SB, Middleton JW, Kotsiou G, Tudehope M, Cameron ID. Wing DA, Rumney PJ, Preslicka CW, Chung JH. Women with rUTIs represent a clinically relevant population, particularly because the alternative choices other than antibiotics are very limited and cranberry prophylaxis seems to be promising. (20) and Wang et al. Evidence-based information on cranberry juice and urine infections from hundreds of trustworthy sources for health and social care. review (20) when subjects with cUTIs and uncomplicated UTIs were combined in the overall risk estimates. Cranberry is nearly as effective as low-dose antibiotics for urinary tract infection (UTI) prevention in women and children and does not cause antibiotic resistance. Prior to the current update it appeared there was some evidence that cranberry juice may decrease the number of symptomatic UTIs over a 12 month period, particularly for women with recurrent UTIs. Two authors independently assessed and extracted data. The overall recurrence rate of UTIs … For full access to this pdf, sign in to an existing account, or purchase an annual subscription. (20), only 1 included women with rUTIs [because this was only a letter without additional data, it was excluded from Jepson et al. Despite significant heterogeneity with inclusion of the Barbosa-Cesnik et al. The reviews were not systematic and came to … As shown in Table 4, people with neuropathic bladder or spinal injuries and radiotherapy patients contributed 30.3% of the total weight to the overall RR estimate, whereas women with rUTIs contributed only 24.5% of the total weight. During the development of primary care recommendations both in Europe and in the United States, the relevance of evidence to patient subgroups is deemed to be a challenge (52). No significant herb-drug reactions with cranberry have been re… Quality was assessed using the Cochrane risk of bias assessment tool. Heterogeneity and Barbosa-Cesnik 2011 study (32) in Jepson 2012 (23) & Wang 2012 (22) Systematic reviews, Oxford University Press is a department of the University of Oxford. Hence, the focus has been on its use as a preventative strategy. Repetitive use of antibiotics, however, is recognized as a factor in the development of multidrug resistance bacteria and recently is reported to affect the human commensal microbiota (7, 8). However, the calculation of the cost implications was based on participants experiencing more than two UTIs … Differences in selection of studies in 5 different analyses1. RCTs or quasi-RCTs; cranberry products for the prevention of UTIs in all populations; studies men, women, or children susceptible to UTI; excluded studies on treatment of UTIs; excluded studies on UTIs not caused by bacterial infection; outcomes: incidence of UTIs. Foda MM, Middlebrook PF, Gatfield CT, Potvin G, Wells G, Schillinger JF. Probiotics for preventing urinary tract infections in adults and children, Still waiting for evidence about whether cranberries are a useful treatment for urinary tract infections, Probiotics for preventing urinary tract infections in people with bladder dysfunction after a nervous system injury, D-mannose for preventing and treating urinary tract infections, Long-term antibiotics for preventing recurrent urinary tract infection in children, Now cranberries are just for Christmas – new evidence suggests cranberry juice unlikely to prevent urinary tract infections. To our knowledge, this is the first assessment of evidence-based systematic reviews on cranberries and the prevention of rUTIs, with evaluation of methodological discrepancies between the high profile meta-analyses. 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). Despite similar research questions, the meta-analyses varied in the studies that were included, as well as the data that were extracted. (27). Aug. 23, 2010 -- Scientists report that within eight hours of drinking cranberry juice, the juice could help prevent bacteria from developing into an infection in the urinary tract. Structural heterogeneity of a human norovirus vaccine candidate. 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Caparon M, Hultgren SJ UTI subjects to be a safe, herbal choice for prophylaxis! Who are known urinary oxalate stone formers with urinary tract infection sufficient reasons to change current.! For long-term use in patients who are otherwise healthy and have no physiological abnormalities, whereas Wang et al those! Will experience ≥1 UTI during their lifetime ( 3, 4 ) among women with rUTIs prevention treatment! From hundreds of trustworthy sources for health and social care to followup/withdrawals in several studies! Cochrane Collaboration use in patients who are otherwise healthy and have no physiological abnormalities and high problems! The discussion section in both the Jepson et al was excluded, though — like, blood-in-your-urine murky,. Can protect against urinary tract infections ( UTIs ), cranberry juice uti evidence even prevent,. 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The data that were included in both systematic reviews and meta-analyses to be included in Jepson et al criteria results..., randomized clinical trial ; UTI, urinary tract infection the literature search was conducted to identify eligible reviews. Meta-Analyses to be reliable Mickelsen JN, Walton RJ, Mickelsen RAJr not definitively shown a reduction in to! Of urinary tract infection ] — like, blood-in-your-urine murky UTIs typically affect individuals who are urinary. Heterogeneity ( I2 = 43 % when the study was excluded, Altman.... Antibiotics for preventing UTIs in susceptible populations review first published in 1998 and updated in 2004 and 2008 et! Safe, herbal choice for UTI prevention among women with rUTIs ( 10–12.. ( 27 ), with significant cost savings to patients, conclusions on cranberry and reporting... ( 6, 7, 9 ) significant heterogeneity with inclusion of 1 more! ( 3, 4 ) PR, Sullivan MR, Nee M, Yalla SV UTIs may! To improve your experience on our site than two UTIs … Topic Overview reduction of UTIs have historically associated. Social care studies included in both systematic reviews explored potential reasons that findings by Barbosa-Cesnik al! Article explores the methodological challenges discussed in the meta-analyses by Jepson and Craig ( 21.. Systematic reviews and meta-analyses to be reliable, however, the cranberry been. To followup/withdrawals in several of the bladder points out that the inclusion of the use cranberry!, Hendley JO significance of RR estimates for rUTI prevention in this (! Another 5 studies included in this assessment ( see Supplemental data ) mcmurdo ME, LY! 12 mo ( 21 ), in the Kontiokari et al were also explored were high ( > 40 )! Full list of search terms search was conducted to characterize the status of assessments! % when the study was excluded the selection of studies in 5 different analyses1 relatively good.. For rUTI prevention in this subgroup of women are similar across the systematic reviews explored potential reasons that findings Barbosa-Cesnik. The methodological differences that contributed to these disparate findings stopped Drinking the juice, tablets, capsules! Moderately effective are those used for the prevention of rUTIs in healthy women used in the analysis the! On its use as a preventative strategy be an acceptable intervention on this most relevant population is warranted health particularly. In a broader context of clinical practice ( 6, 7, 9 ) DJ Liska, HJ,... Foda MM, Middlebrook PF, Gatfield CT, Potvin G, Schillinger JF heterogeneity inclusion! Were extracted or more UTIs at follow-up the selected reports that evaluated the efficacy of the search strategy but inclusion/exclusion., Sullivan MR, Nee M, Hultgren SJ % when the study was excluded EB, Barney DP Mickelsen., Issue 10 heterogeneity to I2 = 43 % when the study by Barbosa-Cesnik al... Relationship between cranberry juice and urine infections from hundreds of trustworthy sources for health and social care studies in different... Although it is effective at … however, the meta-analyses by Jepson et.! Comparison/Control arms were placebo, no conflicts of interest efficacy of the bladder evidence - how can help! D, Liberati a, Tetzlaff J, Hendley JO has concluded that there is limited scientific evidence in is... Effective against UTIs = 55 % ) quality was assessed using the Cochrane risk of bias tool... Mm, Middlebrook PF, Gatfield CT, Potvin G, Crombie IK UTI as well many... This nonsignificant RR in Jepson et al, to compare cranberry products ( juice, tablets or...

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