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Cranberry for Prevention of Urinary Tract Infection?

Cranberry for Prevention of Urinary Tract Infection? Opinion EDITORIAL Time to Move On Lindsay E. Nicolle, MD, FRCPC The daily ingestion of cranberry products—juice or capsules— primary outcome, and of restrictive clinical criteria requiring lo- has been promoted as a means to prevent recurrent urinary tract calizing genitourinary findings for identification of sympto- 1 4 infection (UTI) since at least the first half of the last century. matic UTI, the most important secondary outcome. The clini- In that preantibiotic era, acidi- cal ascertainment of symptomatic UTI in elderly women residing fication of the urine was a rec- in long-term care facilities can be problematic. The very high Related article page 1879 ommended treatment for UTI. prevalence of bacteriuria in this population means that the urine Initially, cranberry juice was explored as an approach to treat- culture, while necessary for diagnosis, has no specificity for iden- ing UTI following the observation that it could lower urine pH. tification of symptomatic infection. In addition, symptomatic This is attributed to formation of hippuric acid through me- infection is often inappropriately diagnosed through attribu- tabolism of the quinic acid present in cranberry juice. Later stud- tion of nonlocalizing nonspecific symptoms—such as in- ies reported that the concentration of hippuric acid http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Cranberry for Prevention of Urinary Tract Infection?

JAMA , Volume 316 (18) – Nov 8, 2016

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Publisher
American Medical Association
Copyright
Copyright 2016 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2016.16140
pmid
27787544
Publisher site
See Article on Publisher Site

Abstract

Opinion EDITORIAL Time to Move On Lindsay E. Nicolle, MD, FRCPC The daily ingestion of cranberry products—juice or capsules— primary outcome, and of restrictive clinical criteria requiring lo- has been promoted as a means to prevent recurrent urinary tract calizing genitourinary findings for identification of sympto- 1 4 infection (UTI) since at least the first half of the last century. matic UTI, the most important secondary outcome. The clini- In that preantibiotic era, acidi- cal ascertainment of symptomatic UTI in elderly women residing fication of the urine was a rec- in long-term care facilities can be problematic. The very high Related article page 1879 ommended treatment for UTI. prevalence of bacteriuria in this population means that the urine Initially, cranberry juice was explored as an approach to treat- culture, while necessary for diagnosis, has no specificity for iden- ing UTI following the observation that it could lower urine pH. tification of symptomatic infection. In addition, symptomatic This is attributed to formation of hippuric acid through me- infection is often inappropriately diagnosed through attribu- tabolism of the quinic acid present in cranberry juice. Later stud- tion of nonlocalizing nonspecific symptoms—such as in- ies reported that the concentration of hippuric acid

Journal

JAMAAmerican Medical Association

Published: Nov 8, 2016

References