Comparing cranberry compounds to increased fluids in the management of urinary tract infections

Objective: <br/>Urinary tract infections (UTIs) are among the most common bacterial infections, impacting over 50% of females and 20% of males throughout their lifetimes. While there have been many past studies comparing the benefits of increased fluids [1] or cranberry drinks to no treatments at all, it is not clear if one option is more advantageous than the other. This study employed a novel methodology called a network meta-analysis to assess three interventions simultaneously: no treatment; cranberry drinks; and increased fluids. The aim was to identify if recommending liquids and/or cranberry compounds is effective in the prevention, management, and treatment of UTIs.<br/><br/>Methods: <br/>This systematic review and network meta-analysis was reported in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) for Network Meta-analyses (NMA) extension checklist, and an a prior protocol was registered on the Open Science Framework. The databases PubMed, Embase, and Cochrane CENTRAL were searched for randomised controlled trials. Studies of individuals of any age or gender who were at risk for UTIs and compared at least two of either cranberry non-liquid products, cranberry liquid, liquid other than cranberry, or no treatment as their interventions. The primary outcome was the number of UTIs, and the secondary outcomes were UTI symptoms and antimicrobial consumption.<br/><br/>Results: <br/>Following the screening of 3278 references initially returned from the search, a total of 20 trials with 3091 participants were included in this study. The population included 88.8% females, and the average age ranged from 4-87 years. The results from 18 studies included in the network meta-analysis highlighted a 54% lower rate of UTIs with cranberry juice consumption than no treatment and a 27% lower rate than placebo liquid. Cranberry juice also resulted in a 49% lower rate of antibiotic use than placebo liquid and a 59% lower rate than no treatment, based on a network meta-analysis of six studies. The use of cranberry compounds also reduced the prevalence of symptoms associated with UTIs.<br/><br/>Conclusions: <br/>The findings from this systematic review and network meta-analysis indicate that increasing liquids reduces the rate of UTIs compared with no treatment, but cranberry in liquid form is even more beneficial at reducing UTIs and antibiotic use [2]. The evidence supports the use of cranberry juice for the prevention of UTIs and should be considered for its management.