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Tsiakoulias E, Gravas S, Hadjichristodoulou C, Oikonomou KG, Kyritsi M, Dadouli K, Matziri A, Kola K, Vacthsioli E, Tsiakoulia M, Gianniou M, Tzortzis V. Randomized, placebo-controlled, double-blinded study of prophylactic cranberries use in women with recurrent uncomplicated cystitis. World J Urol 2024; 42:27. [PMID: 38214795 DOI: 10.1007/s00345-023-04741-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/17/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Τhe adherence of p-fimbriated Escherichia coli (E. coli) to urothelial cells leading to recurrent urinary tract infections (rUTIs) may be prevented by proanthocyanidins (PACs) contained in American cranberries. PURPOSE The purpose of this clinical trial was to assess the clinical utility of prophylactic use of high-dose PACs daily in women with a history of rUTIs. MATERIALS AND METHODS 172 adult women with a history of rUTIs, defined as ≥ 2 within a 6-month period or ≥ 3 within a 12-month period were enrolled and randomized in two groups to receive either Cysticlean™ 240 mg or placebo for a 12-month period. Urine samples, vaginal and rectal swabs were collected at initial and quarterly study visits. The primary study endpoints were the number of urinary tract infections (UTIs) and changes in Quality of Life (QoL), assessed by the 36-Item Short Form Survey (SF-36) questionnaire. RESULTS 160 adult women of median age 40 years old (range 19-82) were finally analyzed in this randomized, placebo-controlled, double-blinded clinical trial. In response to intervention, the number of UTIs was significantly lower (Incidence rate ratio IRR 0.49, p < 0.001) and QoL was slightly improved. The numbers of E. coli isolates detected in vaginal (IRR 0.71, p value < 0.001) and in rectal swabs (IRR 0.87, p value < 0.001) were also significantly decreased. No adverse events were reported. CONCLUSION The daily use of Cysticlean™ 240 mg was associated with a reduction of UTIs and a prolongation of UTI-free survival compared to placebo treatment, supporting its use as prophylaxis in this patient population. TRIAL REGISTRATION Clinicaltrials.gov, identifier NCT03032003.
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Affiliation(s)
- Eleftherios Tsiakoulias
- Department of Urology, School of Health Sciences, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, 41110, Larissa, Greece.
| | - Stavros Gravas
- Department of Urology, Medical School, University of Cyprus, Nicosia, Cyprus
| | | | - Katerina G Oikonomou
- Intensive Care Unit, General Hospital of Larissa, 41221, Larissa, Thessaly, Greece
| | - Maria Kyritsi
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222, Larissa, Greece
| | - Katerina Dadouli
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222, Larissa, Greece
| | - Alexia Matziri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222, Larissa, Greece
| | - Konstantina Kola
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222, Larissa, Greece
| | - Evangelia Vacthsioli
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222, Larissa, Greece
| | - Marianna Tsiakoulia
- Department of Occupational Therapy, Melathron Agoniston EOKA, 4549, Limassol, Cyprus
| | - Michaela Gianniou
- Department of Immunology and Histocompatibility, Faculty of Medicine, University of Thessaly, 41500, Larissa, Greece
| | - Vassilios Tzortzis
- Department of Urology, School of Health Sciences, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, 41110, Larissa, Greece
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