Cranberries and lactobacilli are less effective than antibiotics in preventing urinary tract infections
Antibiotics are the most effective way to prevent urinary tract infections (UTIs), according to Dutch scientists, but they cause problems with antibiotic resistance.
Between 50% and 70% of all women suffer from UTIs throughout their life, 20% to 30% of these women have recurrent infections.
Infections are more common in postmenopausal women. Antibiotics are effective in preventing urinary tract infections, which can decrease over time when the microorganisms that cause infections become resistant.
Researchers believe that a decrease in estrogen levels leads to a decrease in the number of lactobacilli, which creates greater opportunities for colonization by pathogenic microorganisms, in particular Escherichia coli.
In young women, intercourse is a major risk factor. The results of some studies have shown that using vaginal cream with estrogen can reduce the number of relapses of urinary tract infections, but some women do not want to use it. This fact prompted some researchers to study the capacity of food supplements containing lactobacilli to replace lactobacilli in the natural flora of the vagina.
Many women use cranberry juice because fructose and proanthocyanidins can interfere with E. coli at uroepithelial cell receptors.
The 52nd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) presented the results of two studies evaluating the effectiveness of a preparation of tablets containing cranberry extract and lactobacilli compared to antibiotics in preventing infections recurrent urinary in women, and the 52nd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) also a meta-analysis to study alternative treatment regimens for this pathology.
Researchers defined recurrent urinary tract infections as 3 episodes of infection per year or 2 episodes of infection in the previous month.
In the first study, 127 postmenopausal women with recurrent urinary tract infections received trimethoprim / sulfamethoxazole 480 mg for 12 months. The second group (125 women) took capsules containing Lactobacillus rhamnosus GR-1 and L. reuteri RC-14 orally twice a day.
The average total number of exacerbations of urinary tract infections after 12 months of treatment was 2.9 in the trimethoprim / sulfamethoxazole group and 3.3 in the lactobacillus group. The percentage of women with urinary tract infections was also slightly higher in the lactobacilli group (p = 0.02).
Based on the data obtained, it was concluded that antibiotics are superior to lactobacilli in their effectiveness in preventing urinary tract infections. However, when the pathogens were analyzed (in particular, E. coli), it was found that women taking antibiotics had a much higher frequency of release of resistant pathogens.
Similar results were obtained in a direct comparative study of the prophylactic efficacy of a preparation of tablets containing cranberry extract and trimethoprim / sulfamethoxazole in the same populations.
After 12 months of treatment, the average number of exacerbations of UTI was 4.0 per 110 women who received 500 mg of cranberry extract twice a day, and 1.8 per 111 women who received prescribed trimethoprim / sulfamethoxazole (p = 0.02). In addition, 78% of women receiving cranberry extract experienced an exacerbation of urinary tract infections, as did 71% of women taking trimethoprim / sulfamethoxazole.
The average delay before the first episode of infection was 4 months in a group of women receiving cranberry extract. However, after 1 month, researchers found an increase in the resistance of E. coli to trimethoprim, trimethoprim / sulfamethoxazole, amoxicillin and ciprofloxacin in women taking trimethoprim / sulfamethoxazole. The resistance level only returned to its original level after 3 months. At the same time, levels of antibiotic resistance have not increased in women taking cranberry extract. The researchers noted that cranberry therapy is not very effective, but for some patients, it is enough.
According to scientists, the most promising drug for preventing recurrent urinary tract infections is OM-89 (Uro-Vaxom), an oral immunostimulant containing bacterial lysates of E. coli. OM-89 has shown greater efficacy compared to placebo in small clinical trials, but most studies are still in progress.
Scientists in Canada admit that cranberries do not have the qualities to consider them as an alternative therapy. Other recent studies have also produced negative results.