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Cranberry Products or Topical Estrogen-Based Therapy for the Prevention of Urinary Tract Infections: A Review of Clinical Effectiveness and Guidelines

Published on: October 27, 2016
Project Number: RC0818-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of cranberry products for the prevention of urinary tract infections?
  2. What is the clinical effectiveness of topical estrogen-based therapy for the prevention of urinary tract infections?
  3. What are the evidence-based guidelines regarding the prevention of urinary tract infections?

Key Message

Evidence of the clinical effectiveness of cranberry products for the prevention of urinary tract infection was identified in three systematic reviews. One high quality systematic review with a meta-analysis found a lack of evidence to support clinical efficacy of cranberry products for all examined populations including women with recurrent urinary tract infections and children. Another high quality systematic review with a meta-analysis found evidence of efficacy for urinary tract infection prophylaxis in children and in women with recurrent urinary tract infections. One additional systematic review specifically focused on pediatric populations also identified evidence of cranberry product prophylaxis. Seven of eight identified randomized controlled trials and all five identified non-randomized studies found statistically significant reductions in urinary tract infection incidence in a variety of patient populations administered cranberry product prophylaxis. The identified guidelines provided mixed recommendations for the use of cranberry product prophylaxis of urinary tract infections. Evidence identified in two systematic reviews on topical estrogen prevention of urinary tract infections in women consistently supported statistically significant clinical efficacy. The identified guidelines provided mixed recommendations for the use of topical estrogen prophylaxis of urinary tract infections. There were no reported observations in the identified evidence of significant adverse events in patients treated with cranberry products or topical estrogen for urinary tract infection prophylaxis.

Tags

diet, infection control, estrogens, urinary tract, urinary tract infections, vaccinium macrocarpon, cranberries, bladder infections, bladder infection, oestrogens, oestrogen