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Cochrane Review Corner: Cranberries for preventing urinary tract infections

Manidip Pal
Manidip PalProfessor & HOD, Obs & Gyn, College of Medicine & JNM Hospital, WBUHS, Kalyani, Nadia, West Bengal, India
Soma Bandyopadhyay
Soma BandyopadhyayProfessor & HOD, Obs & Gyn, Katihar Medical College, Al-Karim University, Katihar, Bihar, India

This Cochrane review was conducted by Gabrielle Williams, Deirdre Hahn, Jacqueline H Stephens, Jonathan C Craig, Elisabeth M Hodson and published in 2023.1

Active ingredient of Cranberry is proanthocyanidins (PACs). PACs prevent the adherence of p-fimbriated Escherichia Coli to the epithelium of urinary bladder, thereby reducing the incidence of urinary tract infection (UTI).

To assess the efficacy of cranberry in prevention of UTI, literature search was made from Cochrane Kidney and Transplant Specialized Register. All randomized controlled trials (RCTs) or quasi-RCTs were included. Total number of studies included was 50 resulting in 8857 randomized participants.

Cranberry products (juice/tablet/capsule) uses were compared with placebo or no specific treatment in 45 studies. 26 of these studies were meta-analyses that assessed for the incidence of symptomatic, culture-verified UTIs while on treatment.

Cranberry probably reduces incidence of recurrent UTI in women with symptomatic, culture-verified UTIs, in children, and in people who have undergone interventions that make them susceptible to UTI. However little or no benefit were observed in elderly institutional person, pregnant women and adult with neuromuscular bladder dysfunction and incomplete bladder emptying.

Cranberry did not show superiority when compared with antibiotics but was found to be beneficial when compared with probiotics. There is no difference in efficacy between various cranberry formulations and doses, and gastrointestinal side effects do not increase.

Overall it concluded that cranberry is beneficial for symptomatic, culture-verified UTIs in women with recurrent UTIs, in children, and in people susceptible to UTIs following interventions.

Reference

1. Williams G, Hahn D, Stephens JH, Craig JC, Hodson EM. Cranberries for preventing urinary tract infections. Cochrane Database of Systematic Reviews 2023, Issue 4. Art. No.: CD001321. DOI: 10.1002/14651858.CD001321.pub6.