Cranberry Extract for Symptoms of acute, Uncomplicated Urinary Tract Infection: A Systematic Review
Background: Effective alternatives to antibiotics for alleviating symptoms of acute infections may be appealing to patients and enhance antimicrobial stewardship. Cranberry-based products are already in wide use for symptoms of acute urinary tract infection (UTI). The aim of this review was to ident...
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doaj-70d4ebf8068241bda7429329b64b96d62020-12-26T00:00:47ZengMDPI AGAntibiotics2079-63822021-12-0110121210.3390/antibiotics10010012Cranberry Extract for Symptoms of acute, Uncomplicated Urinary Tract Infection: A Systematic ReviewOghenekome A. Gbinigie0Elizabeth A. Spencer1Carl J. Heneghan2Joseph J. Lee3Christopher C. Butler4Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UKBackground: Effective alternatives to antibiotics for alleviating symptoms of acute infections may be appealing to patients and enhance antimicrobial stewardship. Cranberry-based products are already in wide use for symptoms of acute urinary tract infection (UTI). The aim of this review was to identify and critically appraise the supporting evidence. Methods: The protocol was registered on PROSPERO. Searches were conducted of Medline, Embase, Amed, Cinahl, The Cochrane library, Clinicaltrials.gov and WHO International Clinical Trials Registry Platform. We included randomised clinical trials (RCTs) and non-randomised studies evaluating the effect of cranberry extract in the management of acute, uncomplicated UTI on symptoms, antibiotic use, microbiological assessment, biochemical assessment and adverse events. Study risk of bias assessments were made using Cochrane criteria. Results: We included three RCTs (<i>n</i> = 688) judged to be at moderate risk of bias. One RCT (<i>n</i> = 309) found that advice to consume cranberry juice had no statistically significant effect on UTI frequency symptoms (mean difference (MD) −0.01 (95% CI: −0.37 to 0.34), <i>p</i> = 0.94)), on UTI symptoms of feeling unwell (MD 0.02 (95% CI: −0.36 to 0.39), <i>p</i> = 0.93)) or on antibiotic use (odds ratio 1.27 (95% CI: 0.47 to 3.43), <i>p</i> = 0.64), when compared with promoting drinking water. One RCT (<i>n</i> = 319) found no symptomatic benefit from combining cranberry juice with immediate antibiotics for an acute UTI, compared with placebo juice combined with immediate antibiotics. In one RCT (<i>n</i> = 60), consumption of cranberry extract capsules was associated with a within-group improvement in urinary symptoms and Escherichia coli load at day 10 compared with baseline (<i>p</i> < 0.01), which was not found in untreated controls (<i>p</i> = 0.72). Two RCTs were under-powered to detect differences between groups for outcomes of interest. There were no serious adverse effects associated with cranberry consumption. Conclusion: The current evidence base for or against the use of cranberry extract in the management of acute, uncomplicated UTIs is inadequate; rigorous trials are needed.https://www.mdpi.com/2079-6382/10/1/12cranberryvaccinium macrocarponherbalurinary tract infectionsystematic reviewantibiotic resistance |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Oghenekome A. Gbinigie Elizabeth A. Spencer Carl J. Heneghan Joseph J. Lee Christopher C. Butler |
spellingShingle |
Oghenekome A. Gbinigie Elizabeth A. Spencer Carl J. Heneghan Joseph J. Lee Christopher C. Butler Cranberry Extract for Symptoms of acute, Uncomplicated Urinary Tract Infection: A Systematic Review Antibiotics cranberry vaccinium macrocarpon herbal urinary tract infection systematic review antibiotic resistance |
author_facet |
Oghenekome A. Gbinigie Elizabeth A. Spencer Carl J. Heneghan Joseph J. Lee Christopher C. Butler |
author_sort |
Oghenekome A. Gbinigie |
title |
Cranberry Extract for Symptoms of acute, Uncomplicated Urinary Tract Infection: A Systematic Review |
title_short |
Cranberry Extract for Symptoms of acute, Uncomplicated Urinary Tract Infection: A Systematic Review |
title_full |
Cranberry Extract for Symptoms of acute, Uncomplicated Urinary Tract Infection: A Systematic Review |
title_fullStr |
Cranberry Extract for Symptoms of acute, Uncomplicated Urinary Tract Infection: A Systematic Review |
title_full_unstemmed |
Cranberry Extract for Symptoms of acute, Uncomplicated Urinary Tract Infection: A Systematic Review |
title_sort |
cranberry extract for symptoms of acute, uncomplicated urinary tract infection: a systematic review |
publisher |
MDPI AG |
series |
Antibiotics |
issn |
2079-6382 |
publishDate |
2021-12-01 |
description |
Background: Effective alternatives to antibiotics for alleviating symptoms of acute infections may be appealing to patients and enhance antimicrobial stewardship. Cranberry-based products are already in wide use for symptoms of acute urinary tract infection (UTI). The aim of this review was to identify and critically appraise the supporting evidence. Methods: The protocol was registered on PROSPERO. Searches were conducted of Medline, Embase, Amed, Cinahl, The Cochrane library, Clinicaltrials.gov and WHO International Clinical Trials Registry Platform. We included randomised clinical trials (RCTs) and non-randomised studies evaluating the effect of cranberry extract in the management of acute, uncomplicated UTI on symptoms, antibiotic use, microbiological assessment, biochemical assessment and adverse events. Study risk of bias assessments were made using Cochrane criteria. Results: We included three RCTs (<i>n</i> = 688) judged to be at moderate risk of bias. One RCT (<i>n</i> = 309) found that advice to consume cranberry juice had no statistically significant effect on UTI frequency symptoms (mean difference (MD) −0.01 (95% CI: −0.37 to 0.34), <i>p</i> = 0.94)), on UTI symptoms of feeling unwell (MD 0.02 (95% CI: −0.36 to 0.39), <i>p</i> = 0.93)) or on antibiotic use (odds ratio 1.27 (95% CI: 0.47 to 3.43), <i>p</i> = 0.64), when compared with promoting drinking water. One RCT (<i>n</i> = 319) found no symptomatic benefit from combining cranberry juice with immediate antibiotics for an acute UTI, compared with placebo juice combined with immediate antibiotics. In one RCT (<i>n</i> = 60), consumption of cranberry extract capsules was associated with a within-group improvement in urinary symptoms and Escherichia coli load at day 10 compared with baseline (<i>p</i> < 0.01), which was not found in untreated controls (<i>p</i> = 0.72). Two RCTs were under-powered to detect differences between groups for outcomes of interest. There were no serious adverse effects associated with cranberry consumption. Conclusion: The current evidence base for or against the use of cranberry extract in the management of acute, uncomplicated UTIs is inadequate; rigorous trials are needed. |
topic |
cranberry vaccinium macrocarpon herbal urinary tract infection systematic review antibiotic resistance |
url |
https://www.mdpi.com/2079-6382/10/1/12 |
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