Use of cranberry in chronic urinary tract infections

Objective. - Chronic cystitis in women is frequent and difficult to treat. Up to now, an empirical prescription of antibiotics could decrease the frequency of acute episodes but with adverse effects and increasing risks of resistance. Studies have shown that cranberries should be used for that indication. We made a systematic review of literature to demonstrate how to use the cranberry. Results. - Randomized studies confirmed that the proanthocyanidin contained in cranberries can eliminate Escherichia coli adhesion to the urothelium. Clinical studies showed that the incidence of acute cystitis decreased when treated by cranberries. On the other hand, patients with a neurogenic bladder and intermittent catheterization do not seem to benefit from the fruit. We did not find any study on postcoital use of cranberries. Various substances and doses were used in these studies and we could not conclude on best galenic presentation to prescribe. Conclusion. - Cranberries can inhibit E. coli adhesion to the urothelium and could be useful to treat urinary infections. Clinical studies confirm the probable benefit of this fruit as a prophylactic treatment for female cystitis. Prescriptions modalities remain to be defined. (C) 2006 Elsevier SAS.