Abstract
Abstract : A urinary tract infection (UTI) is a bacterial infection of any part of the urinary system. It is estimated that in a women’s lifetime, 50-60 % will develop at least one UTI. Recurrence is common with about 25 % of women suffering a second episode within 6 months of their first UTI. UTIs are commonly treated with antibiotics however, antibiotic treatment does not prevent recurrences and increasing rates of multi-drug resistant uropathogens and adverse effects of antibiotic exposure have raised awareness about the need for complementary treatment approaches. Anecdotal evidence and research suggest that cranberry-derived proanthocyanidins (PACs) help to prevent uropathogenic bacteria from adhering to the walls of the urinary tract, thereby providing a complementary approach to the treatment and prevention of UTIs. The aim of this systematic review was to determine, evaluate and integrate evidence on the efficacy of cranberry-derived PACs in UTIs. This systematic review was based on available online articles and journals in accordance to the general methods proposed by the Cochrane Handbook for Systematic Reviews of Interventions. Electronic database searching yielded a total of 1 614 studies published between 2012-2017 pertaining to the use of cranberry or PACs in UTIs. By stipulated inclusion/exclusion criteria a total of 21 studies qualified for qualitative synthesis. To assess the risk of bias and methodological quality of individual studies the Cochrane Collaboration’s Risk of Bias Tool (Appendix B) and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Randomised Controlled Trials (RCTs) (Appendix C) were applied. Studies assessed as ‘High risk’ research by the Cochrane Collaboration’s Risk of Bias Tool were excluded leaving a total of 15 studies for final review. Evidence shows the use of cranberry is effective at lowering the incidence of UTIs in healthy women and children susceptible to recurrent UTI (RUTI). Thus, to reduce the use of antibiotic prophylaxis (preventative treatment) cranberry may be recommended to prevent UTI however, evidence to support it as a treatment is insufficient. Due to the large variance of PAC content reported between studies, research that standardises the dose and concentration of active ingredient in the cranberry product is recommended; however, the general consensus supports higher concentrations of PACs (>40 mg) to be more effective.
M.Tech. (Homoeopathy)