TUESDAY, July 26 (HealthDay News) -- Trimethoprim-sulfamethoxazole (TMP-SMX) treatment is more effective than cranberries in preventing recurrent urinary tract infections (rUTIs) among premenopausal women, according to a study published in the July 25 issue of the Archives of Internal Medicine.
Mariëlle A.J. Beerepoot, M.D., from the Academic Medical Center in the Amsterdam, Netherlands, and colleagues compared the effectiveness of cranberries and prophylactic antibiotics in preventing rUTIs among 221 premenopausal women who received either TMP-SMX (480 mg once daily) or cranberry capsules (500 mg twice daily) for a period of 12 months. The main outcome measures were the mean number and proportion of patients with at least one symptomatic UTI, the median time to first UTI, and the development of antibiotic resistance in indigenous Escherichia coli (E. coli).
The investigators found that the cranberry group had a significantly higher mean number (4.0 versus 1.8) and proportion of patients (78.2 versus 71.1 percent) with at least one symptomatic UTI compared to the TMP-SMX group. The median time to development of the first symptomatic UTI was shorter for the cranberry group than the TMP-SMX group (four versus eight months). In the cranberry group. 23.7 percent of fecal and 28.1 percent of asymptomatic bacteriuria E. coli isolates were TMP-SMX resistant after one month, compared to 86.3 and 90.5 percent in the TMP-SMX group, respectively. Increased resistance rates were seen in the E. coli isolates from TMP-SMX group for trimethoprim, amoxicillin, and ciprofloxacin after one month. The cranberry group showed no increased antibiotic resistance.
"In premenopausal women with rUTIs, TMP-SMX, 480 mg once daily, is more effective than cranberry capsules, 500 mg twice daily, for the prevention of rUTIs. However, this should be weighed against the greater development of antibiotic resistance," the authors write.
Supplies for the study were provided by Springfield Nutraceuticals BV, and Tiofarma BV, both in the Netherlands.
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