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Effects of a Cranberry, Probiotic, and Vitamin C Supplement on Recurrent Urinary Tract Infections in Children-A
John Dotis1, Vasiliki Karava2, Antonia Kondou3
1Third Department of Pediatrics, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Insights
A cranberry, probiotic, and vitamin C supplement significantly reduced recurrent urinary tract infections (UTIs) in children. This safe, non-antibiotic approach decreased UTI episodes, offering a promising alternative for pediatric care.
Area of Science:
- Pediatric Nephrology and Urology
- Microbiology and Infectious Diseases
- Nutritional Science
Background:
- Recurrent urinary tract infections (UTIs) pose risks for pediatric renal complications, particularly in children with vesicoureteral reflux (VUR).
- Growing concerns regarding antibiotic resistance and adverse effects necessitate exploration of non-antibiotic interventions for pediatric UTIs.
Purpose of the Study:
- To evaluate the efficacy and safety of a standardized supplement combining cranberry extract, probiotics (Lactobacillus rhamnosus, Bifidobacterium longum), and vitamin C in reducing UTI recurrence in children.
- To assess the impact of the intervention on UTI frequency, pathogen distribution, and tolerability in a pediatric cohort, including those with mild-to-moderate VUR.
Main Methods:
- A prospective, self-controlled observational study involving 39 children aged 3-16 years with recurrent UTIs.
- Participants received a daily supplement (cranberry extract, probiotics, vitamin C) for 6 months, with UTI recurrence compared to a baseline period and a subsequent 6-month observation phase.
- Microbiological analyses, safety monitoring, and tolerability assessments were conducted throughout the study.
Main Results:
- The intervention significantly reduced UTI recurrence, with median episodes decreasing from 3 to 0 (p < 0.001) in children without VUR and from 2 to 0 (p < 0.05) in those with VUR.
- 69.2% of participants remained infection-free during follow-up, and others experienced fewer UTI episodes compared to the pre-supplementation period.
- Escherichia coli remained the predominant pathogen, with minimal shifts in other uropathogens, and the supplement was well tolerated with mild gastrointestinal side effects in 12.8%.
Conclusions:
- A multi-component supplement of cranberry, probiotics, and vitamin C is effective in reducing recurrent pediatric UTIs.
- The supplement demonstrates safety and tolerability, including in children with mild-to-moderate VUR, providing a viable non-antibiotic alternative.
- This intervention effectively decreases the overall infection burden without significant alterations in uropathogen profiles.
Abstract:
Recurrent urinary tract infections (UTIs) are common in children and may lead to long-term renal complications, especially in those with vesicoureteral reflux (VUR). Concerns about antibiotic resistance and side effects of prolonged antibiotic use underscore the need for safe, non-antibiotic alternatives. This prospective, self-controlled observational study evaluated a standardized combination of cranberry extract (36 mg proanthocyanidins daily), probiotics (Lactobacillus rhamnosus and Bifidobacterium longum), and vitamin C (250 mg daily) in 39 children aged 3-16 years, including a subgroup with mild-to-moderate VUR. UTI recurrence was compared before and after the 12-month study period. The supplement was administered for 6 months, followed by a 6-month observation period. Microbiological analyses assessed pathogen distribution. Safety and tolerability were monitored. The intervention significantly reduced UTI recurrence, with median episodes decreasing from 3 to 0 in children without VUR (p < 0.001) and from 2 to 0 in children with VUR (p < 0.05). Overall, 27 of 39 participants (69.2%) remained infection-free throughout follow-up, while the remaining participants experienced a reduced number of UTI episodes compared with the pre-supplementation period. Escherichia coli remained the predominant pathogen, while the diversity of other uropathogens changed minimally, indicating fewer infections rather than microbial shifts. The supplement was well tolerated, with mild gastrointestinal symptoms in 5 of 39 participants (12.8%) and no serious adverse events. Subgroup analyses showed consistent benefit across age and sex, with children having higher baseline UTI frequency experiencing the greatest reduction. A multi-component supplement of cranberry, probiotics, and vitamin C effectively reduced recurrent pediatric UTIs, decreased overall infection burden, preserved E. coli as the main pathogen, and was safe and well tolerated, including in children with mild-to-moderate VUR.
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