It’s estimated that as many as 50% of women suffer from an episode of urinary tract infection at least once in their lifetime with as many as 10% -15% experiencing an episode of urinary tract infection (UTI) in the past12 months. 30% of women experiencing a UTI in their lifetime will suffer from recurrent urinary tract infections.
For many years alternative therapists have recommended to their patients the regular use of cranberries for prevention of urinary tract infections. At the time there were few scientific studies which fully supported their claims. Originally the benefits of cranberries in regards to urinary tract health was thought to be due to its acidic properties similar to Vitamin C which was also recommended at the time for urinary tract health.
A United States study comparing the effectiveness of 5 prevention and management strategies in women with recurrent urinary tract infections published late 2013 concluded daily doses of cranberry were found to be as effective as daily oestrogen in post menopausal women in reducing reoccurrence of UTI in those women at high risk for recurrent UTIs. In this particular study high risk was described as those women experiencing 3 or more urinary infections in the previous 12 months. In the same study daily doses of an antibiotic as a prophylaxis was found to be much more effective.
In high risk premenopausal women low dose prophylactic antibiotic therapy is generally recommended. In 2014, World Health Organisation (WHO) published its first global report on surveillance of antimicrobial resistance. Antimicrobial resistance (AMR) is resistance of a microorganism to an antimicrobial drug that was originally effective for treatment of infections caused by it. Widespread prescribing and use of antimicrobials is putting at risk the ability to treat common infections in the community and hospitals. WHO recommend health professionals across the globe “prescribe and dispense antibiotics only when they are truly needed”.
The active ingredient in cranberries is A-type proanthocyanidins (PACs) which can affect the ability of bacteria from adhering to the bladder wall. Due to the minimal regulation of dietary supplements the amount of A-type proanthocyanidins (PACs) in cranberry juices, extracts and tablets is wildly variable. This makes it difficult in prescribing an appropriate dose of cranberry with any certainty.
Taking into account the World Health Organisations’ strong recommendation regards antimicrobial stewardship it’s important that alternative approaches be considered in treating infections. Scientific research does seem to support the use of cranberries in high risk women experiencing recurrent urinary tract infections.