BMJ 2001;322:1571 ( 30 June )

Papers

Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women

Tero Kontiokari, assistant professor, ^a Kaj Sundqvist, head of department, ^b M Nuutinen, assistant professor, ^a T Pokka, statistician, ^a M Koskela, senior physician, ^c M Uhari, professor. ^a

^a Department of Pediatrics, University of Oulu, Oulu, Fin-90220, Finland, ^b Finnish Student Health Service, Oulu, Finland, ^c Laboratory of Clinical Microbiology, Oulu University Hospital, Oulu, Fin-90220, Finland

Correspondence to: T Kontiokari tero.kontiokari{at}oulu.fi

Objective: To determine whether recurrences of urinary tract infection can be prevented with cranberry-lingonberry juice or with Lactobacillus GG drink.
Design: Open, randomised controlled 12 month follow up trial.
Setting: Health centres for university students and staff of university hospital.
Participants: 150 women with urinary tract infection caused by Escherichia coli randomly allocated into three groups.
Interventions: 50 ml of cranberry-lingonberry juice concentrate daily for six months or 100 ml of lactobacillus drink five days a week for one year, or no intervention.
Main outcome measure: First recurrence of symptomatic urinary tract infection, defined as bacterial growth 10⁵ colony forming units/ml in a clean voided midstream urine specimen.
Results: The cumulative rate of first recurrence of urinary tract infection during the 12 month follow up differed significantly between the groups (P=0.048). At six months, eight (16%) women in the cranberry group, 19 (39%) in the lactobacillus group, and 18 (36%) in the control group had had at least one recurrence. This is a 20% reduction in absolute risk in the cranberry group compared with the control group (95% confidence interval 3% to 36%, P=0.023, number needed to treat=5, 95% confidence interval 3 to 34).
Conclusion: Regular drinking of cranberry juice but not lactobacillus seems to reduce the recurrence of urinary tract infection.

What is already known on this topic Up to 60% of women will have a urinary tract infection and a third of them will have several recurrences Vaccinium berries and products containing lactobacilli may affect the coliform bacteria that cause urinary tract infection What this study adds 50 ml of cranberry-lingonberry juice concentrate daily reduced recurrences of symptomatic urinary tract infection by about half compared with the control group Lactobacillus GG drink had no effect on recurrence Self treatment with cranberry juice may reduce the need for antimicrobials for recurrent urinary tract infection

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