UTI

PECKS + SMPPC - 

S. aureus think bacteremia

Cranberry Juice

Clinical Question

Among older women residing in nursing homes, does administration of cranberry capsules vs. placebo decrease bacteriuria plus pyuria?

Bottom Line

Among female nursing home residents with age ≥65, administration of cranberry capsules was not associated with a reduction of bacteriuria plus pyuria when compared to placebo.

Major Points

Women aged ≥65 are at high risk for bacteriuria plus pyuria. The risk for these women is increased while living in a nursing home. Cranberry products have been used to decrease risk of urinary tract infections (UTIs), but there is little clinical evidence to support this strategy. While UTI is a clinical diagnosis with variability based upon diagnostic approach, bacteriuria and pyuria are objective findings thought to be on the causal pathway of UTI. Should cranberry capsules reduce incident pyuria and bacteriuria among high risk women, this would potentially support its use in prevention of UTI.

Published in 2016 by Juthani-Mehta and colleagues, this study randomized 185 women age ≥65 living in nursing homes with and without a history of bacteriuria plus pyuria to cranberry capsules or placebo for 360 days. At the end of the follow-up period, rates of bacteriuria plus pyuria was similar between groups. There was no difference in the rate of symptomatic UTIs between groups.

This finding of this study is consistent with other evidence. In particular, a 2012 Cochrane review

 found that cranberry products do not reduce the risk of urinary tract infections in susceptible patients. The current study provides further evidence that cranberry products have no benefit in preventing bacteriuria plus pyuria in older nursing home women. The findings by the study by Juthani-Mehta and colleagues further supports these findings.

Of note, this trial included incident UTIs as a secondary outcome. There were few UTIs in each group.