Cranberries may be more effective than antibiotics at tackling URIs, study says

Italian researchers analysed the effects of post-operative supplementation with cranberry extract Anthocran Phytosome​ ​on patients with historical R-UTIs and who were catheterised during a surgical procedure. Four weeks after cranberry treatment there were no reported infections or any recurrence in the three-month follow-up.

This suggests supplementation was more effective than antibiotic treatment, the report authors said: “It demonstrated a decrease in the occurrence of UTI symptoms on the visual analogue scale, the presence of blood cells in urine and the presence of bacterial contamination in the urine.”​

They explain that cranberry extract contains a complex mixture of proanthocyanidins (PACs), flavonols and hydroxycinnamic acids that appear to decrease biofilm formation and reduce inflammation, whereas post-operative antibiotics may complicate and prolong an infection by selecting bacterial strains that are resistant to antibiotic treatment and may be ineffective against inflammation.

“A recent study​​ suggests that the daily intake of 36 mg of PACs contributes to decreasing UTIs and inflammation to the walls of the urinary tract. This may be relevant in the evolution of UTIs in which the inflammatory components may be more important than the actual bacterial contamination.”​

Effect of antibiotics​

Recurrent urinary tract infections (R-UTIs) are common among surgical patients after urinary catheterisation but also in non-surgical patients with lower urinary tract anomalies or anatomical variations, benign prostatic hypertrophy or in patients suffering from partial or temporary obstruction of the urinary tract.

Patients are routinely treated with antibiotics, such as nitrofurantoin ​(recommended by The Infectious Disease Society of America), as the first line of defence to relieve or prevent symptoms associated with UTIs, however researchers maintain that antibiotics administered to treat infections are sometimes inadequate and may even exacerbate the symptoms. “The use of antibiotics during/after surgery may further complicate the infection by selecting bacterial strains that are resistant to antibiotic treatments. R-UTIs may persist for months after surgery if the treatment is not adequate.” ​

There are also cost and health implications with frequent or long-term use of antibiotics, including resistance to medication and reduced efficacy of antimicrobial treatments.

“The long-term use of ​nitrofurantoin has been associated with anaemia, pulmonary toxicity, hepatic disease and neuropathy in some patients. R-UTIs are also a significant source of morbidity and healthcare costs.​

Study results suggest that new post-surgical (PS) supplements may offer, “an interesting alternative solution for preventing R-UTIs, without using antibiotics​”.

Study protocol​

The observational study was supervised by the International Agency for Pharma Standard Supplements (IAPSS) and included 64 healthy subjects requiring non-complicated surgery with urinary catheterisation.

Subjects were excluded from the study if significant bacteria were found on the catheter post-op or if blood was detected in the urine.

Eligible subjects were assigned to one of the two cranberry Anthocran Phytosome​ treatment groups and received a daily supplement dose of either 120mg or 240mg; to the control group with standard management (SM) or treated with nitrofurantoin​ (50mg three times daily) for four weeks.

Anthocran Phytosome ​​is a cranberry product developed by nutraceuticals company Indena and produced from lecithin. The formulation is designed to enhance the distribution of cranberry active ingredients to target organs and comprises 6-9% PACS and has antioxidant and inflammatory properties.

The occurrence of urinary symptoms was evaluated in the four weeks of follow-up. The presence of UTIs were indicated by specific signs or symptoms (for example, dysuria, nocturia, urgency, pain), presence of increased bacterial charge in the urines, visible presence of blood in the urine and need for consultation and specialist evaluation.

Findings suggest Anthocran Phytosome​ prophylaxis constitutes an effective solution to control new possible post-operative and post-catheter UTIs and inflammations in uncomplicated subjects with a previous history of UTIs, with “very promising results in the prevention of UTIs both in young healthy subjects and in older men suffering from benign prostatic hyperplasia”​.

In addition, the researchers testify to “the safety and tolerability profile of this product”,​ due to the complete lack of adverse effects.

Source: Journal of Dietary Supplements​

Published online: doi.org/10.1080/19390211.2021.1972074​​

“Anthocran Phytosome: Prevention of Recurring Urinary Infections and Symptoms after Catheterization”​

Authors: Roberto Cotellese et al.