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Int Urol Nephrol ; 48(9): 1379-86, 2016 Sep.
Article in English | MEDLINE | ID: mdl-27314247

ABSTRACT

PURPOSE: To evaluate the effect of cranberry extract (PAC-A ~ proanthocyanidin-A) on the in vitro bacterial properties of uropathogenic (E. coli) and its efficacy/tolerability in patients with subclinical or uncomplicated recurrent UTI (r-UTI). MATERIALS AND METHODS: After obtaining clearance from the ethics committee and administering a written informed consent, 72 patients with r-UTI were enrolled as per protocol (November 2011 to March 2013) in this prospective study, to randomly receive (PAC-A: group I, 36) or (placebo: group II, 36), for 12 weeks. Any change/reduction in the incidence of r-UTI at 12 weeks was construed to be the primary endpoint of this study. RESULTS: After 12 weeks, bacterial adhesion scoring decreased (0.28)/(2.14) in group I/II (p < 0.001); 32/36 (88.8 %) and 2/36 (5.5 %) in groups I and II, respectively, turned MRHA negative (p < 0.001); biofilm (p < 0.01) and bacterial growth (p < 0.001) decreased in group I; microscopic pyuria score was 0.36/2.0 in group I/II (p < 0.001); r-UTI decreased to 33.33 versus 88.89 % in group I/II (p < 0.001); mean subjective dysuria score was 0.19 versus 1.47 in group I/II (p < 0.001), while mean urine pH was 5.88 versus 6.30 in group I/II (p < 0.001). No in vitro antibacterial activity of cranberry could be demonstrated, and no adverse events were noted. CONCLUSIONS: The overall efficacy and tolerability of standardized cranberry extract containing (PAC-A) as a food supplement were superior to placebo in terms of reduced bacterial adhesion; bacterial MRHA negativity; urine pH reduction; and in preventing r-UTI (dysuria, bacteriuria and pyuria). Larger randomized controlled trials are needed to elucidate the precise role, exact dose and optimal duration of PAC-A therapy in patients at risk of r-UTI.


Subject(s)
Escherichia coli Infections/prevention & control , Phytotherapy , Plant Extracts/therapeutic use , Urinary Tract Infections/prevention & control , Vaccinium macrocarpon/chemistry , Administration, Oral , Adolescent , Adult , Aged , Bacterial Adhesion/drug effects , Biofilms/drug effects , Dietary Supplements , Dysuria/microbiology , Escherichia coli/drug effects , Escherichia coli Infections/complications , Hemagglutination Tests , Humans , Hydrogen-Ion Concentration , Middle Aged , Plant Extracts/pharmacology , Prospective Studies , Pyuria/microbiology , Recurrence , Secondary Prevention , Urinary Tract Infections/microbiology , Urine/chemistry , Young Adult
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