A Probiotic and Cranberry Combination Prevents Urinary Tract Infections in Premenopausal Women

by | Dec 15, 2020 | 2019, Bladder Health, Probiotics, Women's Health

Written by Joyce Smith, BS. A combination of cranberry and probiotics safely and effectively prevented recurrent urinary tract infections in premenopausal women.

cranberriesStudies have shown an association between our microbiome and the treatment and prevention of disease, most notably 1 of which is the microbiome’s influence on physiological processes such as immune function. Probiotics have been used to effectively enhance the composition of beneficial gut microorganisms and diminish pathogenic ones 2. Over 50% of women will experience at least one UTI during their lifetime 3, with 20-30% of them suffering from recurrent infections 4.

UTIs represent a serious financial burden for our health care system. Common UTI pathogens include Enterobacteriaceae family (Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Citrobacter spp. and Enterobacter spp.) 5 Originating in the rectal biota, uropathogenic E. coli (UPEC) comprise 80 % of uncomplicated UTIs, and 95% of community-acquired UTIs 5. Treatment for recurrent UTIs requires continuous low dose antibiotic prophylaxis which can unfortunately lead to antibiotic- resistance 5,6, particularly with respect to UPEC 7,8. Antibiotic use often leads to gut and vaginal dysbiosis only to continue the cycle of recurrent infections.

An interest in natural therapies, such as probiotics and cranberry supplementation for vaginal health, led to the following double blind randomized placebo controlled pilot study 9 that investigated whether a probiotic and cranberry extract (PACs), would preventing recurrent uncomplicated UTIs in premenopausal adult women. Ninety premenopausal women, aged 18 years and older, who experienced two or more UTIs in the last six months or three or more episodes in the last twelve months, received either a placebo or a probiotic containing Lactobacillus acidophilus PXN 35 and Lactobacillus plantarum PXN 47 plus 36 mg daily of cranberry proanthocyanidin extract (PACs) and two capsules daily of vitamin A over a six month duration.

Twenty-six weeks of treatment saw a significant decrease of recurrent UTIs in the intervention (cranberry probiotic group) compared to placebo (9.1% vs 33.3%; P = 0.0053). The intervention group also saw significant improvements in several secondary endpoints compared to the placebo group.

  • A larger number in the intervention group experienced no UTIs than in the placebo group (90% vs 67%; P=0.05).
  • The intervention group experience a longer period of time before the first UTI (174 vs 90 days; P=0.001) and a reduced duration of UTI infections (5 vs 12 days; P=0.009).
  • Fewer women in the intervention group (3 vs 11) required antibiotic treatment and fewer courses of antibiotics (3 vs 14) were needed to treat the UTIs.
  • Average duration of antibiotic treatment was 40% shorter in the cranberry probiotic group than the placebo group (4 vs 7 days; P=0.09.)

Mechanisms of action involved the direct inhibition of the pathogens responsible for UTIs, as well as overall immune stimulation. Probiotics are considered safe for human use and therefore carry negligible risk. The use of a probiotic cranberry combination is a cheaper UTI alternative that could hopefully reduce the use of antibiotics and lessen their chances of developing resistance.

Limitations include the small study size, the absence of biological biomarkers for detecting vaginal and urinary tract infections and the failure to establish whether cranberry and probiotics work better alone or in combination.

Source: Koradia, Parshottam, Shital Kapadia, Yamini Trivedi, Gajendrasinh Chanchu, and Ashton Harper. “Probiotic and cranberry supplementation for preventing recurrent uncomplicated urinary tract infections in premenopausal women: A controlled pilot study.” Expert review of anti-infective therapy 17, no. 9 (2019): 733-740.

© 2019 ADM Protexin Ltd. Published by Informa UK Limited, trading as Taylor & Francis Group.This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Click here to read the full text study.

Posted December 15, 2020.

Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from  the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.

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