Clinical Edge

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Can Cranberry Capsules Help Prevent UTIs?

JAMA; 2016 Nov 8; Juthani-Mehta, Van Ness, et al

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No significant difference in presence of bacteriuria plus pyuria over 1 year was observed among older women in nursing homes following administration of cranberry capsules vs placebo, a recent study found. This double-blind, randomized, placebo-controlled trial included 185 participants (mean age 86.4 years, 90.3% white, 31.4% with bacteriuria plus pyuria at baseline); 147 completed the study. Interventions included 2 cranberry capsules (each 36 mg of the active ingredient proanthocyanidin) vs placebo administered once daily in 92 treatment and 93 control group participants. Researchers found:

• Overall adherence was 80.1%.

• There was no statistically significant difference in presence of bacteriuria plus pyuria between the treatment (29.1%) and control (29.0%) groups over 1 year.

• There were no significant differences in number of symptomatic urinary tract infections (UTIs), rates of death, hospitalization, bacteriuria associated with multidrug-resistant gram-negative bacilli, antibiotics administered for suspected UTIs, or total antimicrobial utilization.

Citation: Juthani-Mehta M, Van Ness PH, Bianco L, et al. Effect of cranberry capsules on bacteriuria plus pyuria among older women in nursing homes: A randomized clinical trial. JAMA. 2016;316(18):1879-1887. doi:10.1001/jama.2016.16141.

Commentary: Asymptomatic bacteriuria is common in nursing home residents and current recommendations suggest not treating asymptomatic bacteriuria.1 This is problematic because these recommendations often are not adhered to and patients receive unnecessary antibiotics. At other times, these patients become febrile and the bacteriurea is implicated as the cause of their febrile illness whether or not it is actually the cause or just an innocent bystander. Some small trials have suggested an effect of cranberry juice on decreasing the incidence of UTIs in women in nursing homes.2 The current study simply does not support a benefit to the use of cranberry capsules for prevention of UTIs or asymptomatic baceriuria in elderly nursing home residents. —Neil Skolnik, MD

1. Juthani-Mehta M, Datunashvili A, Tinetti M. Tests for urinary tract infection in nursing home residents. JAMA. 2014;312(16):1687-1688. doi:10.1001/jama.2014.13554.

2. Bianco L, Perrelli E, Towle V, Van Ness PH, Juthani-Mehta M. Pilot randomized controlled dosing study of cranberry capsules for reduction of bacteriuria plus pyuria in female nursing home residents. J Am Geriatr Soc. 2012;60(6):1180-1181.

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