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An Updated Meta‐Analysis of Cranberry and Recurrent Urinary Tract Infections in Women
Author(s) -
Fu Zhuxuan,
Liska DeAnn,
Talan David,
Chung Mei
Publication year - 2017
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.31.1_supplement.lb343
Subject(s) - medicine , meta analysis , randomized controlled trial , medline , placebo , urinary system , etiology , systematic review , alternative medicine , pathology , political science , law
Objective Cranberry ( Vaccinium microcarpum ) has been advocated for urinary tract infection (UTI); however, its efficacy is controversial. UTIs account for an annual cost of more than $2.6 billion in healthcare expenditures and are common in otherwise healthy women. In fact, a woman has a 50% risk of UTI over her lifetime, with an estimated 20–30% of these women having recurrent UTI (rUTI), most commonly cystitis. Few meta‐analyses have been published on cranberry and UTI, and these have combined data from studies of complicated UTIs with uncomplicated UTI (e.g., cystitis). Given the concerns for antibiotic resistance, and the differences in etiology of complicated and uncomplicated UTIs, we conducted a meta‐analysis on studies in healthy women at risk of rUTI. [Registered on International Prospective Register of Systematic Reviews: PROSPERO 2015CRD42015024439 ]. Method Literature prior to January 2011 was obtained from two published systematic reviews with updated searches conducted in EMBASE (through 2015) and MEDLINE (through November 2016). Inclusion criteria were: randomized controlled trials (RCT), conducted in generally healthy non‐pregnant women aged ≥18 years with a history of rUTI, comparing cranberry intervention to a placebo or control, and reporting the outcome as number of subjects experiencing a UTI. Abstract and full‐text screenings, data extractions, and risk of bias assessments were conducted by two researchers independently. Meta‐analyses were performed using Stata SE (Version 13). A fixed‐effect model using Mantel‐Haenszel (M‐H) method was employed to estimate the summary risk if the heterogeneity was low to moderate (I 2 <50%). Otherwise a random‐effects model using the DerSimonian‐Laird method was applied. Results Seven RCTs in healthy women at risk of rUTI (n= 1498 subjects) were identified. Meta‐analysis found cranberry reduced the risk of rUTI by 23% (pooled RR=0.77; 95% CI: 0.64–0.93; I 2 =47%), and limited data from subgroup analysis suggested cranberry was more effective in interventions with cranberry as a capsule or tablet. Risk of bias indicated three studies had high loss‐to‐follow‐up or selective outcome reporting. Overall, studies were relatively small with only two having more than 300 subjects. Conclusion Results suggest cranberry may be effective in preventing rUTIs in generally healthy women; however, larger high‐quality studies are needed to confirm these findings. Support or Funding Information ZF, MC and DT received no funding for conduct of the study. DL was supported by a grant from Ocean Spray Cranberries, Inc.