Does ‘prevention first’ approach to UTI with cranberry juice have benefits?

Results of a study by Canadian researchers suggest that exposure to low and medium doses of cranberry juice may have potential to reduce physician visits and costs for women who have a history of recurrent urinary tract infection (UTI). The findings were presented at the American Urological Association’s 2018 Annual Meeting in San Francisco and published in The Journal of Urology.

This analysis followed a blinded randomized controlled trial (RCT) of low- and medium-dose cranberry juice for prevention of UTI in 263 community-dwelling women with a history of recurrent UTI. For the research on use of the juice and its impact on healthcare utilization and associated costs, the authors linked data from 123 of the women who were originally randomized to data from Canada’s single-payor government-run healthcare system. ICD-9 codes for cystitis (595), kidney symptoms (589, 590, 593) and lower urinary tract symptoms (788, 780, 999, 789, 596, 791) were targeted to examine healthcare utilization 1 year before the RCT, during it, and 1 year after it.

Administrative algorithms used to identify UTIs were tested for accuracy by comparing them to UTI data during the RCT and assessed for inter-rater reliability using weighted Kappa. All costs including urinalysis within 7 days and number of visits associated with UTI were tabulated for group comparisons including Anova.

Women who took placebo, low and medium doses of cranberry juice saw their general practitioners for UTI a mean of 2.4, 2.2, and 2.3 times in the year before the RCT. Following exposure, visits were lower across all three study arms, with the greatest difference in the women in the low-dose cranberry juice group, who had 64% fewer visits after the RCT. Before the RCT, women had hospital visits for UTI a mean of 2.8, 2.8 and 2.6 times per year if they were taking placebo, low- and medium-dose cranberry juice, respectively. The greatest apparent reduction was in the low-dose group, falling to a mean of one visit per person per year.

The authors concluded that in women with a history of recurrent UTI, exposure to low and medium doses of cranberry juice for 1 year may be associated with fewer visits to clinicians and lower associated healthcare costs.