A study to evaluate the efficacy of cranberry extract supplements in prevention of recurrent urinary tract infections in female patients
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20205122Keywords:
Cranberry, E. coli, Recurrent infections, Symptoms, Urine routine examination, UTIAbstract
Background: Recurrence of urinary tract infections (UTI) are either due to re infection or relapse. Overall likelihood of developing UTI is approximately 30 times higher in women than men due to their anatomical peculiarities. The objective was to evaluate efficacy of cranberry extract supplementations in prevention of recurrent UTI in female patients, assess the quality of life of patients, medication adherence of patients and effect of patient counselling.
Methods: A prospective observational study was carried out for a period of 6 months and samples were taken from the Urology Department of Cosmopolitan Hospital, Trivandrum, Kerala. The selected patients were administered with cranberry extract supplements after their regular Antibiotic therapy and were observed for recurrence for a period of six months. Three follow ups were taken and the betterment was assessed using the score from prepared proforma.
Results: 84 patients were analysed and among them we observed and concluded that 86.9% of patients were free of recurrent infection. Study shows that E. coli was the commonest infectious organism causing UTI. In this study the most commonly observed symptom of UTI was lower abdominal pain and the most common co morbidity was DM.
Conclusions: Through this study it was concluded that the cranberry extract supplements significantly reduced the recurrence of UTI in women. Since the antibiotic prophylaxis is having the risk of developing resistance and side effects, the cranberry extract supplements can be suggested as a best alternative to antibiotics in recurrent UTI prophylaxis.
Metrics
References
Hudson JQ, Chaudhary K. Chronic kidney disease: therapeutic approach for the management of complications. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 6th edn. New York: Medical Publishing Division; 2005:822-827.
Mason DL, Assimon MM. Chronic Kidney Disease. In: Alldredge BK, Corelli RL, Ernst ME, Guglielmo BJ, Jacobson PA, Kradjan WA, et al, eds. Koda-kimble and Young’s applied therapeutics: the clinical use of drugs. 10th edn. Wolters Kluwer Health Adis (ESP); 2013:764-767.
Marriott J, Cockwell P, Stringer S. Chronic kidney disease and end stage renal disease. In: Walker R, Whittlesea C, eds. Clinical Pharmacy and Therapeutics, 5th ed. London: Churchill Livingstone Elsevier; 2012:272-276.
Tripathi KD. Antihypertensive drugs. In, Tripathi KD, ed. Essentials of Medical Pharmacology, 8th edn. New Delhi: Jaypee Brothers Medical Publishers; 2019;604-618.
Mohan H. The kidney and lower urinary tract. In: Text Book of Pathology; 7th edn. New Delhi: Jaypee Brothers Medical Publishers; 2015:651-656.
David Machin, Simon Day, Sylvan Green. Text book of clinical trial. 2nd edn. John Wiley and Sons; 2010:593-594.
Ravishankar K, Kiranmayi GVN. Clinical pharmacy and pharmacotherapeutics. 2nd edn. PharmaMed Press; 2018:365.
Colledge NR, Walker BR, Ralston SH. Davidson’s Principal and Practice of Medicine, 21st edn. Elsevier Health Science; 2010:459.
Greene RJ, Harris ND. Pathology and Therapeutics for Pharmacist: A basis for clinical pharmacy practice. 3rd edn. Pharmaceutical Press; 2008:903.
British National Formulary. BMJ group and Pharmaceutical Press; 2012:18.
Nseir W, Farah R, Mahamid M, Sayed-Ahmad H, Mograbi J, Taha M, et al. Obesity and recurrent urinary tract infections in premenopausal women: a retrospective study. Int J Infect Dis. 2015;41:32-5.
Polewski MA, Krueger CG, Reed JD, Leyer G. Ability of cranberry proanthocyanidins in combination with a probiotic formulation to inhibit in vitro invasion of gut epithelial cells by extra-intestinal pathogenic E. coli. J Funct Foods. 2016;25:123-34.
Dune T, Hilt E, Price T, Brincat C, Fitzgerald C, Brubaker L, et al. Specific urinary tract infection symptoms in women relate to urinary organisms. In: Neurourology and urodynamics. 2016;35:S108-9.
Raz R, Chazan B, Dan M. Cranberry juice and urinary tract infection. Clinical infectious diseases. 2004 May 15;38(10):1413-9.
Price TK, Dune T, Hilt EE, Thomas-White KJ, Kliethermes S, Brincat C, et al. The clinical urine culture: enhanced techniques improve detection of clinically relevant microorganisms. J Clin Microbiol. 2016;54(5):1216-22.
Chang SJ, Lin CD, Hsieh CH, Liu YB, Chiang IN, Yang SS. Reliability and validity of a Chinese version of urinary tract infection symptom assessment questionnaire. Int Braz J Urol. 2015;41(4):729-38.
Makwana SP, Solanki MN. Comparative analysis of safety and efficacy of cefotaxime/sulbactam verses piperacillin/tazobactam combinations in the treatment of complicated urinary tract infections. Int J Basic Clin Pharmacol. 2019;8(3):512.
Howella A, Souzab D, Rollerc M, Fromentinb E. Comparison of the anti-adhesion activity of three different cranberry extracts on uropathogenic p-fimbriated Escherichia coli: a randomized, double-blind, placebo controlled, ex vivo acute study. Natur Product Commun. 2015;10(7);1215-8.
Liska DJ, Kern HJ, Maki KC. Cranberries and urinary tract infections: how can the same evidence lead to conflicting advice? Adv Nutrition. 2016;7(3):498-506.
Valentová K, Stejskal D, Bednář P, Vostálová J, Číhalík Č, Večeřová R, et al. Biosafety, antioxidant status, and metabolites in urine after consumption of dried cranberry juice in healthy women: a pilot double-blind placebo-controlled trial. J Agricult Food Chemist. 2007;55(8):3217-24.
Clayson D, Wild D, Doll H, Keating K, Gondek K. Validation of a patient‐administered questionnaire to measure the severity and bothersomeness of lower urinary tract symptoms in uncomplicated urinary tract infection (UTI): the UTI Symptom Assessment questionnaire. BJU Int. 2005;96(3):350-9.
Jepson RG, Williams G, Craig JC. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. 2012(10).
Ahmed H, Farewell D, Jones HM, Francis NA, Paranjothy S, Butler CC. Antibiotic prophylaxis and clinical outcomes among older adults with recurrent urinary tract infection: cohort study. Age Ageing. 2019;48(2):228-34.
Uberos J. Efficacy and safety profile of cranberry in infants and children with recurrent urinary tract infection. Analesdepediatria. 2014(20):2341-879.
Sobota AE. Inhibition of bacterial adherence by cranberry juice: potential use for the treatment of urinary tract infections. J Urol. 1984;(131):1013-6.
Foo LY, Howell AB, Vorsa N. A-type proanthocyanidins trimmers from cranberry that inhibit adherence of uropathogenic p-fimbriated E. coli. J Nat Prod. 2000;(63):1225-8.
Ledda A, Belcaro G, Dugall M, Riva A, Togni S, Eggenhoffner R, et al. Highly standardized cranberry extract supplementation (Anthocran®) as prophylaxis in young healthy subjects with recurrent urinary tract infections. Eur Rev Med Pharmacol Sci. 2017;21(2):389-93.
McMurdo ME, Argo I, Phillips G, Daly F, Davey P. Cranberry or trimethoprim for the prevention of recurrent urinary tract infections? A randomized controlled trial in older women. J Antimicrob Chemotherap. 2009;63(2):389-95.
Wing DA, Rumney PJ, Preslicka CW, Chung JH. Daily cranberry juice for the prevention of asymptomatic bacteriuria in pregnancy: a randomized, controlled pilot study. J Urol. 2008;180(4):1367-72.