Cranberry juice to prevent catheter-associated urinary tract infection

Catheter-associated bacteriuria is the most common healthcare–associated infection worldwide. It’s due to the widespread use of urinary catheterization.

An Expert Panel of the Infectious Diseases Society of America reviewed the evidence and made recommendations to minimize this risk. Here’s what they say about cranberry juice.

To start, bacteriuria denotes the presence of bacteria in urine. Urinary tract infection is an infection of the kidneys, ureters (tubes joining the kidneys to the bladder), bladder, and urethra (tube leading from the bladder to outside the body). It may be associated with symptoms (frequent urge to urinate, pain, burning) or be symptom free.

Summary of the evidence

• Urinary tract infections
  • There’s some evidence that cranberry may effectively reduce symptomatic urinary tract infections in young women with recurrent urinary tract infections.
  • Effectiveness for other groups is uncertain, including elderly men and women or people requiring urinary catheterization.
• Neurogenic bladder (interference with the normal nerve pathways associated with urination)
  • Studies of cranberry to prevent catheter-associated-bacteriuria or catheter-associated urinary tract infection in patients with neurogenic bladders are mostly negative.
    • But the quality of the studies is poor.
  • In addition to the cost, cranberry therapy is associated with tolerance during  long-term use.
• Condom catheterization (a flexible sheath over the penis)
  • It may be reasonable to consider a trial of cranberry in men who use condom catheterization who have recurrent episodes of catheter-associated urinary tract infection.
• Catheterized adults without neurogenic bladder
  • There are no published data on the use of cranberry products to prevent of catheter-associated-bacteriuria or catheter-associated urinary tract infections in these adults.

The bottom line?

According to the panel members, “The most effective way to reduce the incidence of catheter-associated asymptomatic bacteriuria and catheter-associated urinary tract infection is to reduce the use of urinary catheterization by restricting its use to patients who have clear indications and by removing the catheter as soon as it is no longer needed.”

12/19/10 17:49 JR