Ethics in Medicine

Cranberry Juice versus Antibiotics: You Decide

Kristen Sparrow • July 25, 2011

An article from the New York Times comparing cranberry juice versus months of low dose antibiotics. No surprise that the antibiotic helped keep the infections away to a larger degree, and also no surprise that it lead to E Coli resistant strains that are harder to treat. I mentioned in a previous post that I have a patient who was treated for months for bladder infections and ended up with Clostridia Dificile infection, a life threatening intestinal infection. She was hospitalized for days with a few of them in the ICU. So, like I said, you decide…

Downside for a Urinary Infection Remedy

Women with recurrent urinary tract infections sometimes must take low-dose antibiotics for months to control the problem. Many prefer to try something less onerous, like cranberry extract or juice, which several studies have suggested can prevent these infections.

But a new study finds that a commonly used antibiotic works much better than cranberry, with one significant drawback: It encourages the development of resistant strains of bacteria.

Dutch researchers randomly assigned 221 women with a history of infections to two groups. The first took a daily dose of 480 milligrams of Bactrim, an antibiotic, and the second took 1,000 milligrams of cranberry extract.

The study, published Monday in The Archives of Internal Medicine, found that by any of three measures — the number of symptomatic infections, the proportion of patients with at least one infection or the average time to the first infection after starting the regimens — antibiotics controlled the infections more effectively in the study participants.

But when the researchers tested the subjects’ urine and feces, they found a large increase in the presence of antibiotic-resistant strains of E. coli, the most common cause of the infections, in those who used the antibiotic.

Dr. Suzanne E. Geerlings, the senior author and an infectious disease specialist at the Academic Medical Center of the University of Amsterdam, said the findings did not rule out using cranberry and noted that antibiotics have risks. “Antibiotics work better,” she said, “but when you get an infection resistant to antibiotics, you have a bigger problem.”

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