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用于预防儿科患者尿路感染的蔓越莓产品

Cranberry Products for the Prophylaxis of Urinary Tract Infections in Pediatric Patients.

作者信息

Durham Spencer H, Stamm Pamela L, Eiland Lea S

机构信息

Auburn University Harrison School of Pharmacy, Auburn, AL, USA

Auburn University Harrison School of Pharmacy, Auburn, AL, USA.

出版信息

Ann Pharmacother. 2015 Dec;49(12):1349-56. doi: 10.1177/1060028015606729. Epub 2015 Sep 23.

Abstract

OBJECTIVE

To evaluate the existing data regarding the use of cranberry products for the prevention of urinary tract infections (UTIs) in pediatric patients.

DATA SOURCES

A literature search of Medline databases from 1966 to June 2015 was conducted.

STUDY SELECTION AND DATA EXTRACTION

The databases were searched using the terms "pediatrics," "children," "cranberry," "cranberry juice," and "urinary tract infections." The identified trials were then searched for additional references applicable to this topic.

DATA SYNTHESIS

A total of 8 clinical trials were identified that examined the use of cranberry products, mostly juice, for the prevention of UTIs in children. Three trials examined the use in otherwise healthy children. Five trials examined the use in pediatric patients with underlying urogenital abnormalities of which 2 compared cranberry to antibiotics. In healthy pediatric patients, cranberry use was associated with a reduction in the overall number of UTIs and a decrease in the number of antibiotic days per year for UTI treatment. In patients with urogenital abnormalities, results were conflicting, with some studies showing no reduction in UTIs compared with placebo, but others demonstrating a significant reduction. However, cranberry products had similar efficacy when compared with both cefaclor and trimethoprim. All studies used a wide variety of doses and frequencies of cranberry, making specific product recommendations difficult.

CONCLUSIONS

Cranberry appears effective for the prevention of UTIs in otherwise healthy children and is at least as effective as antibiotics in children with underlying urogenital abnormalities. However, recommendations for cranberry dosing and frequency cannot be confidently made at this time. Larger, well-designed trials are recommended.

摘要

目的

评估现有关于蔓越莓产品用于预防儿科患者尿路感染(UTIs)的数据。

数据来源

对1966年至2015年6月的Medline数据库进行了文献检索。

研究选择与数据提取

使用“儿科”“儿童”“蔓越莓”“蔓越莓汁”和“尿路感染”等术语对数据库进行检索。然后对所识别的试验进行搜索,以查找适用于该主题的其他参考文献。

数据综合

共识别出8项临床试验,这些试验研究了蔓越莓产品(主要是果汁)用于预防儿童尿路感染的情况。3项试验研究了在其他方面健康的儿童中的使用情况。5项试验研究了在有潜在泌尿生殖系统异常的儿科患者中的使用情况,其中2项试验将蔓越莓与抗生素进行了比较。在健康的儿科患者中,使用蔓越莓与尿路感染总数的减少以及每年用于治疗尿路感染的抗生素使用天数的减少相关。在有泌尿生殖系统异常的患者中,结果相互矛盾,一些研究表明与安慰剂相比尿路感染没有减少,但其他研究则显示有显著减少。然而,与头孢克洛和甲氧苄啶相比,蔓越莓产品具有相似的疗效。所有研究使用了多种蔓越莓的剂量和服用频率,因此难以给出具体的产品推荐。

结论

蔓越莓似乎对预防其他方面健康的儿童的尿路感染有效,并且在有潜在泌尿生殖系统异常的儿童中至少与抗生素一样有效。然而,目前无法自信地给出蔓越莓的剂量和服用频率建议。建议进行更大规模、设计良好的试验。

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