Urinary Tract Infection: Should Cranberry and Probiotics Be Considered?

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Abstract

Urinary tract infection (UTI) is one of the most common afflictions worldwide, with most occurring as uncomplicated UTI in the lower urinary tract (ie, cystitis) in otherwise healthy women. In fact, a woman has 50% risk of a experiencing an episode of cystitis over her lifetime. Most concerning is that a third to half these women have a UTI recurrence within a year. Antibiotics have been the main approach for treating UTIs and are also used as a prophylaxis in women prone to UTI recurrence. However, the rapid rise of multidrug resistant uropathogens has become an issue, and nonantibiotic approaches to prevention of UTI are of clinical interest. In addition, the recent discovery of a urinary tract microbiome has furthered the interest in these nonantibiotic approaches to UTI, and both cranberry and probiotics have putative mechanisms for decreasing uropathogens in the microbiome. Cranberries have historically been associated with urinary tract health, but the literature has been mixed. Although data are limited for cranberry as a treatment for UTI, the evidence for cranberry products (eg, fruit powder capsules, cranberry juices) in preventing recurrence of uncomplicated UTI in women is positive. Therefore, cranberry may be a promising nonantibiotic option for decreasing the risk of recurrent UTI in otherwise healthy women. Although less extensively studied, certain beneficial live microorganisms, also known as probiotics, have been suggested as alternatives to antibiotics in the prevention of uncomplicated UTIs; however, data on oral intake of probiotics, particularly via food, are limited.

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