Original Article
Spinal Cord (2008) 46, 622–626; doi:10.1038/sc.2008.25; published online 8 April 2008
Evaluation of cranberry tablets for the prevention of urinary tract infections in spinal cord injured patients with neurogenic bladder
M J Hess1, P E Hess2, M R Sullivan3, M Nee2 and S V Yalla3
- 1Department of Spinal Cord Injury, VA Boston Health Care System, West Roxbury, MA, USA
- 2Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- 3Department of Urology, VA Boston Health Care System, West Roxbury, MA, USA
Correspondence: Dr MJ Hess, Department of Spinal Cord Injury, VA Boston Health Care System, Building 2, 1400 VFW Parkway, West Roxbury, MA 02132, USA. E-mail: Marika.hess@med.va.gov
Received 11 March 2007; Revised 3 December 2007; Accepted 15 December 2007; Published online 8 April 2008.
Abstract
Study Design:
Randomized, double blind, placebo-controlled trial with a crossover design.
Objective:
To evaluate cranberry tablets for the prevention of urinary tract infection (UTI) in spinal cord injured (SCI) patients.
Setting:
Spinal Cord Injury Unit of a Veterans Administration Hospital, MA, USA.
Methods:
Subjects with spinal cord injury and documentation of neurogenic bladder were randomized to receive 6 months of cranberry extract tablet or placebo, followed by the alternate preparation for an additional 6 months. The primary outcome was the incidence of UTI.
Results:
Forty-seven subjects completed the trial. We found a reduction in the likelihood of UTI and symptoms for any month while receiving the cranberry tablet (P<0.05 for all). During the cranberry period, 6 subjects had 7 UTI, compared with 16 subjects and 21 UTI in the placebo period (P<0.05 for both number of subjects and incidence). The frequency of UTI was reduced to 0.3 UTI per year vs 1.0 UTI per year while receiving placebo. Subjects with a glomerular filtration rate (GFR) greater than 75 ml min-1 received the most benefit.
Conclusion:
Cranberry extract tablets should be considered for the prevention of UTI in SCI patients with neurogenic bladder. Patients with a high GFR may receive the most benefit.
Sponsorship:
Spinal Cord Research Foundation, sponsored by the Paralyzed Veterans of America
Keywords:
cranberry, spinal cord injury, neurogenic bladder, urinary tract infection
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