Issue: October 2012
September 11, 2012
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Antibiotic prophylaxis bested cranberry capsules for recurrent UTIs

Issue: October 2012
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SAN FRANCISCO — The use of cranberry capsules for the prevention of urinary tract infections was less effective than low-dose antibiotics, according to research presented here at the 52nd Interscience Conference on Antimicrobial Agents and Chemotherapy.

Perspective from Donald Kaye, MD

However, when considering prophylaxis options, physicians should also consider the development of resistance among the normal flora, Suzanne Geerlings, MD, PhD, an infectious diseases specialist at the Academic Medical Center in Amsterdam, said at a press conference here.

Suzanne Geerlings, MD 

Suzanne Geerlings

“It was difficult to perform this trial because most of the women wanted to be in the non-antibiotic arm,” Geerlings said. “Women know that if they take antibiotics for long periods of time, they may develop resistance. They also know that once they get an infection, it will be more difficult to treat.”

Geerlings and colleagues conducted a double blind, double dummy, noninferiority trial in which 221 premenopausal women with recurrent UTIs were randomly assigned to prophylaxis with once-daily 480 mg trimethoprim-sulfamethoxazole or twice-daily 500 mg cranberry capsules.

After receiving treatment for 1 year, the proportion of patients experiencing at least one symptomatic UTI was higher among the women who had received the cranberry capsules: four compared with 1.8 (P=.02). Among those who received cranberry capsules, the median time to first symptomatic UTI was 4 months compared with 8 months among those who received the antibiotic.

Among those who received the antibiotic, the researchers found increased resistance rates to trimethoprim, TMP-SMX, amoxicillin and ciprofloxacin to Escherichia coli isolates in the normal flora, 1 month after discontinuing treatment, but the resistance returned to baseline levels after 3 months. There was no resistance observed among women who received the cranberry capsules.

For more information:

Geerlings S. #542. Presented at: 52nd ICAAC; Sept. 9-12, 2012; San Francisco.

Disclosure: Geerlings reports no relevant financial disclosures.