title: Cranberry juice capsules and urinary tract infection after surgery: results of a randomized trial.
abstract: OBJECTIVE
  The risk of urinary tract infection (UTI) among women undergoing elective gynecological surgery during which a catheter is placed is high: 10-64% following catheter removal. We conducted the first randomized, double-blind, placebo-controlled trial of the therapeutic efficacy of cranberry juice capsules in preventing UTI after surgery.
  
  
  METHODS
  We recruited patients from a single hospital between August 2011 and January 2013. Eligible participants were undergoing elective gynecological surgery that did not involve a fistula repair or vaginal mesh removal. One hundred sixty patients were randomized and received 2 cranberry juice capsules 2 times a day, equivalent to 2 8 ounce servings of cranberry juice, for 6 weeks after surgery or matching placebo. The primary endpoint was the proportion of participants who experienced clinically diagnosed and treated UTI with or without positive urine culture. Kaplan-Meier plots and log rank tests compared the 2 treatment groups.
  
  
  RESULTS
  The occurrence of UTI was significantly lower in the cranberry treatment group compared with the placebo group (15 of 80 [19%] vs 30 of 80 [38%]; odds ratio, 0.38; 95% confidence interval, 0.19-0.79; P = .008). After adjustment for known confounders, including the frequency of intermittent self-catheterization in the postoperative period, the protective effects of cranberry remained (odds ratio, 0.42; 95% confidence interval, 0.18-0.94). There were no treatment differences in the incidence of adverse events, including gastrointestinal upset (56% vs 61% for cranberry vs placebo).
  
  
  CONCLUSIONS
  Among women undergoing elective benign gynecological surgery involving urinary catheterization, the use of cranberry extract capsules during the postoperative period reduced the rate of UTI by half.
authors.affiliation: Center for Molecular and Clinical Epidemiology of Infectious Diseases and Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI. Electronic address: bfoxman@umich.edu.
authors.forename: Betsy
authors.initials: B
authors.lastname: Foxman
authors.affiliation: Center for Molecular and Clinical Epidemiology of Infectious Diseases and Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI.
authors.forename: Anna E W
authors.initials: AE
authors.lastname: Cronenwett
authors.affiliation: Department of Biostatistics and Statistical Analysis of Biomedical and Educational Research unit, University of Michigan School of Public Health, Ann Arbor, MI.
authors.forename: Cathie
authors.initials: C
authors.lastname: Spino
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan School of Medicine, Ann Arbor, MI.
authors.forename: Mitchell B
authors.initials: MB
authors.lastname: Berger
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan School of Medicine, Ann Arbor, MI.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Morgan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D005638:Fruit; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use*; D014546:Urinary Catheterization; D014552:Urinary Tract Infections / Q000517:prevention & control*; D029799:Vaccinium macrocarpon; D055815:Young Adult
chemical_list: D010936:Plant Extracts
keywords: catheter-associated urinary tract infection; clinical trial; cranberry extract