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Vaccinium macrocarpon is characterized by the presence of type A proanthocyanidins (PACs) thought able, by interacting directly with type-P fimbrial structures found in uropathogenic strains, to prevent recurrent cystitis. According to clinical evidence the PAC dose needed seems to be 36 mg, when analyzed with a method called DMAC. Due to the use of different types of analytical method, most of European products whose labels read 36 mg PACs/dose actually give values lower than stated, lacking of reproducibility. Moreover the “36 mg” issue, entericcoating, limiting the environmental oxidative stress over the PAC fraction of cranberry and avoiding the PACs to interact with gastric H. pilori, optimizes efficacy of cranberry extract as demonstrated in clinical trials carried out in patients at risk for developing cystitis during pelvis radiotherapy, in patients with a diagnosis of recurrent cystitis and in patients with episodes of acute cystitis. In conclusion the real efficacy of a Vaccinium macrocarpon preparation can be assessed only after applying to the extract proper standardization and dosing procedures and taking into consideration the need of coating the finished product in order to protect PACs

The Need for a More Exact Analytical Characterization and Dosing of Cranberry Extract in Relation with its Actual Therapeutic Properties