The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog is intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.

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    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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    Cranberries vs antibiotics to prevent urinary tract infection

    Concern over the risk of resistance to antimicrobial agents has stimulated interest in cranberries to prevent recurrent urinary tract infections (UTIs).

    Researchers in the Netherlands compared trimethoprim-sulfamethoxazole (TMP-SMX) (Septra, Bactrim) to cranberry capsules.

    First, the details.

    • 221 premenopausal women with recurrent UTIs were randomly assigned to a treatment group for 12 months.
      • TMP-SMX 480 mg once daily
      • Cranberry capsules 500 mg twice daily
    • The average number of symptomatic UTIs over 12 months, the proportion of patients with at least 1 symptomatic UTI, the time to first urinary tract infection, and development of antibiotic resistance in indigenous Escherichia coli were recorded.
    • Neither the patients nor researchers knew the treatment given — double blind.

    And, the results.

    • The average number of patients with at least 1 symptomatic UTI was significantly higher in the cranberry vs the TMP-SMX group (4.0 vs 1.8, respectively).
    • The proportion of patients with at least 1 symptomatic UTI was higher in the cranberry vs TMP-SMX group (78% vs 71%).
    • The time to the first symptomatic UTI was 4 months for the cranberry and 8 months for the TMP-SMX group.
    • After 1 month, in the cranberry group, 24% of fecal and 28% of asymptomatic bacteriuria E coli isolates were TMP-SMX resistant.
      • In the TMP-SMX group, 86% of fecal and 91% of asymptomatic bacteriuria E coli isolates were TMP-SMX resistant.
    • There were increased resistance rates for trimethoprim, amoxicillin, and ciprofloxacin in these E coli isolates after 1 month in the TMP-SMX group.
    • After discontinuation of TMP-SMX, resistance returned to baseline levels after 3 months.
    • Antibiotic resistance did not increase in the cranberry group.
    • Cranberries and TMP-SMX were equally well tolerated.

    The bottom line?

    The authors concluded, “In premenopausal women TMP-SMX, 480 mg once daily is more effective than cranberry capsules 500 mg twice daily to prevent recurrent UTIs.

    However, “This was achieved at the expense of emerging antibiotic resistance.”

    There’s lots of interest in cranberries to prevent UTIs. It’s important to not lump the results from different populations of patients or different formulations of cranberry. Here’s a review of what we know.

    7/26/11 21:23 JR

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