Spinal Cord Injury

SCI: Cranberry Juice and Urinary Tract Infections (2007)

Cranberry Juice and Urinary Tract Infections (Phase 2 of the SCI evidence analysis project 2007-2008)

• Intervention
  Does cranberry juice have a positive impact on urologic health (prevention of urinary tract infections, stone formation, etc) in persons with Spinal Cord Injury?

  • Conclusion

    One (1) nonrandomized crossover trial (quality rating neutral) found that adherence of bacteria to uroepithelial cells was significantly decreased in spinal cord injured patients who consumed 250 ml cranberry juice three (3) times per day. Cranberry juice intake resulted in a significant reduction in urinary tract biofilm load compared to baseline (P=0.013) and to water treatment (P=0.028). This study was limited by its small size (N = 15), and was funded by a manufacturer of cranberry juice. Further research is needed to determine the role of cranberry juice in preventing urinary tract infections in spinal cord injured patients.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Does cranberry juice have a positive impact on urologic health (prevention of urinary tract infections, stone formation, etc)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Reid G, Hsiehl J, Potter P, Mighton J, Lam D, Warren D, Stephenson J. Cranberry juice consumption may reduce biofilms on uroepithelial cells: pilot study in spinal cord injured patients.  Spinal Cord. 2001;39:26-30.
  • Search Plan and Results: Cranberry juice and urologic health 2007
     
  Do cranberry extract supplements have a positive impact on urologic health (prevention of urinary tract infections, stone formation, etc.) in persons with spinal cord injury?

  • Conclusion

    Three (3) double-blind, randomized, controlled trials (one with positive quality rating, two with neutral quality ratings), found that cranberry extract supplements, ingested in tablet or capsule form, are not effective in prolonging the UTI-free period, or decreasing bacteriuria or WBC count, in people with spinal cord injuries.  The study receiving a positive quality rating was a large study (N = 305).  The amount of cranberry extract administered was similar between studies (1600 mg, 1200 mg, 1200 mg).  Further research is needed to determine the role of cranberry extract supplements in spinal cord injured patients.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Do cranberry extract supplements have a positive impact on urologic health (prevention of urinary tract infections, stone formation, etc.?)
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Lee BB, Haran MJ, Hunt LM, Simpson JM, Marial O, Rutkowski SB, Middleton JW, Kotsiou G, Tudehope M, Cameron ID. Spinal-injured neuropathic bladder antisepsis (SINBA) trial. Spinal Cord. 2007;45:542-550. 
      •  Linsenmeyer TA, Harrison B, Oakley A, Kirshblum S, Stock JA, Millis SR. Evaluation of cranberry supplement for reduction of urinary tract infections in individuals with neurogenic bladders secondary to spinal cord injury. A prospective, double-blinded, placebo-controlled, crossover study. J Spinal Cord Med. 2004;27:29-34.
      • Waites K, Canupp K, Armstrong S, DeVivo M. Effect of cranberry extract on bacteriuria and pyuria in persons with neurogenic bladder secondary to spinal cord injury. J. Spinal Cord Med. 2004;27:35-40.
  • Search Plan and Results: Cranberry juice and urologic health 2007