Moro Christian, Phelps Charlotte, Veer Vineesha, Jones Mark, Glasziou Paul, Clark Justin, Tikkinen Kari A O, Scott Anna Mae
Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.
Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.
Eur Urol Focus. 2024 Dec;10(6):947-957. doi: 10.1016/j.euf.2024.07.002. Epub 2024 Jul 18.
With over 50% of women suffering from at least one episode of urinary tract infection (UTI) throughout their lifetime and an increasing prevalence of antimicrobial resistance, efforts need to be made to clearly identify the evidence supporting potential non-drug interventions. This study aims to compare the effects of cranberry juice, cranberry tablets, and increased liquids for the management of UTIs.
PubMed, Embase, and Cochrane CENTRAL were searched for randomised controlled trials. The primary outcome was the number of UTIs, and the secondary outcomes were UTI symptoms and antimicrobial consumption. A risk of bias assessment was performed using the Cochrane risk of bias tool, and the certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation.
A total of 20 trials (3091 participants) were included, with 18 studies highlighting a 54% lower rate of UTIs with cranberry juice consumption than no treatment and a 27% lower rate than placebo liquid. Cranberry juice also resulted in a 49% lower rate of antibiotic use than placebo liquid and a 59% lower rate than no treatment, based on a network meta-analysis of six studies. The use of cranberry compounds also reduced the prevalence of symptoms associated with UTIs.
With moderate to low certainty, the evidence supports the use of cranberry juice for the prevention of UTIs. While increased liquids reduce the rate of UTIs compared with no treatment, cranberry in liquid form provides even better clinical outcomes in terms of reduction in UTIs and antibiotic use and should be considered for the management of UTIs.
With the increasing prevalence of antimicrobial-resistant UTIs, alternate non-drug treatment options for its management are required. Available evidence supports the use of cranberry compounds and increases in fluid intake for managing UTIs.
超过50%的女性在一生中至少经历过一次尿路感染（UTI），且抗菌药物耐药性日益普遍，因此需要努力明确支持潜在非药物干预措施的证据。本研究旨在比较蔓越莓汁、蔓越莓片和增加液体摄入量对尿路感染管理的效果。
检索PubMed、Embase和Cochrane CENTRAL以查找随机对照试验。主要结局是尿路感染的次数，次要结局是尿路感染症状和抗菌药物使用情况。使用Cochrane偏倚风险工具进行偏倚风险评估，并使用推荐分级的评估、制定与评价（GRADE）对证据的确定性进行评估。
共纳入20项试验（3091名参与者），18项研究表明，饮用蔓越莓汁的尿路感染发生率比不治疗低54%，比安慰剂液体低27%。基于六项研究的网络荟萃分析，蔓越莓汁的抗生素使用率也比安慰剂液体低49%，比不治疗低59%。使用蔓越莓化合物还降低了与尿路感染相关的症状发生率。
证据以中低确定性支持使用蔓越莓汁预防尿路感染。虽然增加液体摄入量与不治疗相比可降低尿路感染发生率，但液体形式的蔓越莓在降低尿路感染和抗生素使用方面提供了更好的临床结果，在尿路感染管理中应予以考虑。
随着耐抗菌药物性尿路感染的患病率不断上升，需要其他非药物治疗选择来进行管理。现有证据支持使用蔓越莓化合物和增加液体摄入量来管理尿路感染。
