Evaluation of cranberry tablets for the prevention of urinary tract infections in spinal cord injured patients with neurogenic bladder.
METHODS
Randomized, double blind, placebo-controlled trial with a crossover design.


OBJECTIVE
To evaluate cranberry tablets for the prevention of urinary tract infection (UTI) in spinal cord injured (SCI) patients.


METHODS
Spinal Cord Injury Unit of a Veterans Administration Hospital, MA, USA.


METHODS
Subjects with spinal cord injury and documentation of neurogenic bladder were randomized to receive 6 months of cranberry extract tablet or placebo, followed by the alternate preparation for an additional 6 months. The primary outcome was the incidence of UTI.


RESULTS
Forty-seven subjects completed the trial. We found a reduction in the likelihood of UTI and symptoms for any month while receiving the cranberry tablet (P<0.05 for all). During the cranberry period, 6 subjects had 7 UTI, compared with 16 subjects and 21 UTI in the placebo period (P<0.05 for both number of subjects and incidence). The frequency of UTI was reduced to 0.3 UTI per year vs 1.0 UTI per year while receiving placebo. Subjects with a glomerular filtration rate (GFR) greater than 75 ml min(-1) received the most benefit.


CONCLUSIONS
Cranberry extract tablets should be considered for the prevention of UTI in SCI patients with neurogenic bladder. Patients with a high GFR may receive the most benefit.


BACKGROUND
Spinal Cord Research Foundation, sponsored by the Paralyzed Veterans of America.
Hess
M J
MJ
Department of Spinal Cord Injury, VA Boston Health Care System, West Roxbury, MA, USA. Marika.hess@med.va.gov
Hess
P E
PE
Sullivan
M R
MR
Nee
M
M
Yalla
S V
SV
D000328:Adult; D000368:Aged; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005919:Glomerular Filtration Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006863:Hydrogen-Ion Concentration / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010919:Placebos; D010936:Plant Extracts / Q000008:administration & dosage*; D044945:Proanthocyanidins / Q000494:pharmacology / Q000627:therapeutic use; D013119:Spinal Cord Injuries / Q000150:complications*; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000150:complications*; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000209:etiology* / Q000382:microbiology; D014556:Urine / Q000737:chemistry / Q000382:microbiology; D019459:Urothelium / Q000187:drug effects / Q000502:physiology; D029799:Vaccinium macrocarpon
D010919:Placebos; D010936:Plant Extracts; D044945:Proanthocyanidins; C013221:proanthocyanidin