Urinary Tract Infections in Older Adults: Cranberry
Urinary Tract Infections in Older Adults: Cranberry
September 2, 2024
Joy Stepinski, MSN, RN-BC
Last month we discussed the common problem of urinary tract infections (UTIs) among older adults. The severity of UTIs can range from asymptomatic (without any symptoms) to sepsis [1]. Sepsis occurs as a result of pathogens entering the bloodstream causing an infection and may require hospitalization. Hydration is one strategy to prevent an infection. A second is cranberries.
What is so special about cranberries? A photochemical Type-A proanthocyanidin prevents the adherence of bacteria to the urinary tract lining due to its unique structural properties. The first published clinical study on the use of cranberries occurred in 1966. Of 60 patients who drank 480 mL of cranberry juice daily for three weeks, 53% positively affected the prevention of urinary tract infections. After stopping the treatment after six weeks, bacteria reappeared in the urine [2].
One study of 538 skilled nursing home residents consumed 220 mL of cranberry juice or six capsules of cranberry extract daily. Findings showed that urinary tract infections decreased by seven cases per month.
Another study compared the treatment of UTIs using trimethoprim-sulfamethoxazole, an antibiotic, or a cranberry extract among premenopausal women [3]. The findings showed that antibiotic resistance was more prevalent with antibiotic prophylaxis (85%) than the cranberry treatment (30%). In the short term, the antibiotic was more effective due to the bioavailability of the treatments. Overall, the study showed great potential for cranberries because antibiotic resistance is a growing problem leading to the inability to treat infections.
Other investigators isolated 39 strains of E. coli pathogens in women aged 18 – 39 after drinking 240 mL of cranberry juice, compared with the same antibiotic. Cranberry juice also showed protection from the bacteria adhering to the urinary epithelial cells and red blood cells [4].
Drinking 240 mL (8 oz) of cranberry juice daily may be effective in decreasing UTIs and avoiding the ramifications of antibiotics.
References:
1. Rodriguez-Mañas, L. (2020). Urinary tract infections in the elderly: a review of disease characteristics and current treatment options. Drugs in Context, 9. https://doi.org/10.7573/dic.2020-4-13
2. Raz, R., Chazan, B., & Dan, M. (2004). Cranberry juice and urinary tract infection. Clinical infectious diseases, 38(10), 1413-1419.
3. Gurley, B. J. (2011). Cranberries as Antibiotics?: Comment on “Cranberries vs Antibiotics to Prevent Urinary Tract Infections: A Randomized Double-Blind Noninferiority Trial in Premenopausal Women”. Archives of Internal Medicine, 171(14), 1279-1280.
4. Howell, A. B., & Foxman, B. (2002). Cranberry juice and adhesion of antibiotic-resistant uropathogens. Jama, 287(23), 3082-3083.with urinary tract infection in a nursing home. Revista Brasileira de Enfermagem, 74(Suppl 2), e20200813.