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Review

Cranberry Extract for Symptoms of Acute, Uncomplicated Urinary Tract Infection: A Systematic Review

Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK
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Antibiotics 2021, 10(1), 12; https://doi.org/10.3390/antibiotics10010012
Received: 26 November 2020 / Revised: 22 December 2020 / Accepted: 23 December 2020 / Published: 25 December 2020
(This article belongs to the Section Antibiotics Use and Antimicrobial Stewardship)
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 (n = 688) judged to be at moderate risk of bias. One RCT (n = 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), p = 0.94)), on UTI symptoms of feeling unwell (MD 0.02 (95% CI: −0.36 to 0.39), p = 0.93)) or on antibiotic use (odds ratio 1.27 (95% CI: 0.47 to 3.43), p = 0.64), when compared with promoting drinking water. One RCT (n = 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 (n = 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 (p < 0.01), which was not found in untreated controls (p = 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. View Full-Text
Keywords: cranberry; vaccinium macrocarpon; herbal; urinary tract infection; systematic review; antibiotic resistance cranberry; vaccinium macrocarpon; herbal; urinary tract infection; systematic review; antibiotic resistance
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MDPI and ACS Style

Gbinigie, O.A.; Spencer, E.A.; Heneghan, C.J.; Lee, J.J.; Butler, C.C. Cranberry Extract for Symptoms of Acute, Uncomplicated Urinary Tract Infection: A Systematic Review. Antibiotics 2021, 10, 12. https://doi.org/10.3390/antibiotics10010012

AMA Style

Gbinigie OA, Spencer EA, Heneghan CJ, Lee JJ, Butler CC. Cranberry Extract for Symptoms of Acute, Uncomplicated Urinary Tract Infection: A Systematic Review. Antibiotics. 2021; 10(1):12. https://doi.org/10.3390/antibiotics10010012

Chicago/Turabian Style

Gbinigie, Oghenekome A., Elizabeth A. Spencer, Carl J. Heneghan, Joseph J. Lee, and Christopher C. Butler 2021. "Cranberry Extract for Symptoms of Acute, Uncomplicated Urinary Tract Infection: A Systematic Review" Antibiotics 10, no. 1: 12. https://doi.org/10.3390/antibiotics10010012

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