Overview
Recurrent bacterial cystitis is defined as two or more urinary tract infections (UTIs) within a six-month period or three or more within a 12-month period 1. It is often associated with the adherence of p-fimbriated Escherichia coli to urothelial cells 1.Diagnosis
Management
Prophylactic use of high-dose proanthocyanidins (PACs) from American cranberries may reduce the incidence of UTIs 1.
Daily use of Cysticlean™ 240 mg was associated with a significant reduction in UTIs and a slight improvement in Quality of Life in a randomized trial 1.
Cranberry PACs may also decrease the isolation of E. coli* from vaginal and rectal swabs 1.Special Populations
Key Recommendations
Daily prophylactic use of high-dose PACs (e.g., Cysticlean™ 240 mg) may be considered for women with recurrent uncomplicated cystitis to reduce UTI incidence 1. (Evidence: Strong)
Prophylactic cranberry PACs may lead to a decrease in E. coli colonization in the vaginal and rectal flora, potentially contributing to UTI prevention 1. (Evidence: Moderate)References
1 Tsiakoulias E, Gravas S, Hadjichristodoulou C, Oikonomou KG, Kyritsi M, Dadouli K et al.. Randomized, placebo-controlled, double-blinded study of prophylactic cranberries use in women with recurrent uncomplicated cystitis. World journal of urology 2024. link