Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women
BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7302.1571 (Published 30 June 2001) Cite this as: BMJ 2001;322:1571
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Sir, I would like to point out some interpretational problems of the
present study which are caused by inaccurate use of the name "cranberry".
The study was planned to further substantiate the beneficial effects of
juice from the American cranberry (Vaccinium macrocarpon) for prophylaxis
of urinary tract infections. The american cranberry is indeed on old folk
remedy in North-America and it has been shown that ingredients of that
berry interfere with bacterial adhesion to mucosa. All these data, which
come from research with the American cranberry are cited to explain the
results of the present study. However, as mentioned only once in the text,
juice from the American cranberry was not studied here. A mixture of
Lingonberry-juice and of juice from the European cranberry (V. oxycoccus)
was studied. To my knowledge there are not many data on ingredients of the
European cranberry available. Do they also contain a high amount of
proanthocyanides which prevent bacterial adhesíon? They may do, since the
species are closely related botanically. Nevertheless, I think it has to
be made much clearer here, that juice from a closely related but different
fruit has been applied in this study.
Competing interests: No competing interests
Randomization means a random allocation of subjects to one of the
study groups. Blinding means that they don´t know what they will receive.
This study was randomized but not blinded.
Best regards, Tero Kontiokari
Competing interests: No competing interests
Reading This article about a "randomised" study on drinks, given in
different quantities and, perhaps, colours: I actually I have some doubts
about the correct planning of this trial: how could this study be
randomised, beeng the enrolled persons clearly able to distinguish between
the three preparations?
Competing interests: No competing interests
Zafriri (1) showed that the fructose in cranberry juice was about
1/10 as selective for the mannose lectins on type 1 pili, but was still
sufficient to block adherence of the bacteria to cellular mannose.
King (2) showed that mannose prevented adherence of Pseudomonas,
Strep. xooepidemicus, as well as E coli to equiine endometrial tissue. She
also saw a dose dependent retrograde movement of spermatozoa in the
presence of higher concentrations of mannose (personal communication).
Maybe the time will come that we can use simple sugars such as these
to prevent post coital UTI's as well as unwanted pregancies.
1. Zafriri D, Ofek I, Adar R, Pocino M, Sharon N. Inhibitory activity
of cranberry juice on adherence of type 1 and type P fimbriated
Escherichia coli to eukartotic cells. Antimicrob Agents Chemother 1989
Jan;33(1):92-8.
2. King SS, Young DA, Nequin LG, Carnevale EM. Use of specific sugars
to inhibit bacterial adherence to equine endometrium in vitro. Am J Vet
Res 2000 Apr;61(4):446-9.
Competing interests: No competing interests
The mistake is not in the abstract of the article itself. It's in
"This week in the BMJ".
...surely not an editorial error!
Competing interests: No competing interests
I suggest that Ms Neumann reads the abstract once again. I can only
find right figure (16%) in both abstract and text. Furthermore, the amount
of cranberry was 50 ml, not 5ml as stated in comment.
Best regards, Tero Kontiokari
Competing interests: No competing interests
I wish to draw your attention to an inaccuracy in the abstract
reporting the results of the trial of cranberry juice for recurrent
urinary tract infection. The full article suggests that 16% of women using
5 ml of cranbberry juice had recurrent infections whereas the abstract
reports that only 1% of women had recurrence. For those who read only the
abstact, this suggests a far greater efficacy than was really the case.
Yours sincerely
Trish Neumann
Competing interests: No competing interests
baseline characteristics
There is a fairly large difference -(between 15(34%)in the cranberry
group and 20(43%) in the control group) in the frequency of sexual
intercourse >3 times per week during follow -up. Do you think that this
could have affected outcomes?
Competing interests:
None declared
Competing interests: No competing interests