| Title |
Effect of Cranberry Capsules on Bacteriuria Plus Pyuria Among Older Women in Nursing Homes: A Randomized Clinical Trial
|
|---|---|
| Published in |
JAMA: Journal of the American Medical Association, November 2016
|
| DOI | 10.1001/jama.2016.16141 |
| Pubmed ID | |
| Authors |
Manisha Juthani-Mehta, Peter H. Van Ness, Luann Bianco, Andrea Rink, Sabina Rubeck, Sandra Ginter, Stephanie Argraves, Peter Charpentier, Denise Acampora, Mark Trentalange, Vincent Quagliarello, Peter Peduzzi |
| Abstract |
Bacteriuria plus pyuria is highly prevalent among older women living in nursing homes. Cranberry capsules are an understudied, nonantimicrobial prevention strategy used in this population. To test the effect of 2 oral cranberry capsules once a day on presence of bacteriuria plus pyuria among women residing in nursing homes. Double-blind, randomized, placebo-controlled efficacy trial with stratification by nursing home and involving 185 English-speaking women aged 65 years or older, with or without bacteriuria plus pyuria at baseline, residing in 21 nursing homes located within 50 miles (80 km) of New Haven, Connecticut (August 24, 2012-October 26, 2015). Two oral cranberry capsules, each capsule containing 36 mg of the active ingredient proanthocyanidin (ie, 72 mg total, equivalent to 20 ounces of cranberry juice) vs placebo administered once a day in 92 treatment and 93 control group participants. Presence of bacteriuria (ie, at least 105 colony-forming units [CFUs] per milliliter of 1 or 2 microorganisms in urine culture) plus pyuria (ie, any number of white blood cells on urinalysis) assessed every 2 months over the 1-year study surveillance; any positive finding was considered to meet the primary outcome. Secondary outcomes were symptomatic urinary tract infection (UTI), all-cause death, all-cause hospitalization, all multidrug antibiotic-resistant organisms, antibiotics administered for suspected UTI, and total antimicrobial administration. Of the 185 randomized study participants (mean age, 86.4 years [SD, 8.2], 90.3% white, 31.4% with bacteriuria plus pyuria at baseline), 147 completed the study. Overall adherence was 80.1%. Unadjusted results showed the presence of bacteriuria plus pyuria in 25.5% (95% CI, 18.6%-33.9%) of the treatment group and in 29.5% (95% CI, 22.2%-37.9%) of the control group. The adjusted generalized estimating equations model that accounted for missing data and covariates showed no significant difference in the presence of bacteriuria plus pyuria between the treatment group vs the control group (29.1% vs 29.0%; OR, 1.01; 95% CI, 0.61-1.66; P = .98). There were no significant differences in number of symptomatic UTIs (10 episodes in the treatment group vs 12 in the control group), rates of death (17 vs 16 deaths; 20.4 vs 19.1 deaths/100 person-years; rate ratio [RR], 1.07; 95% CI, 0.54-2.12), hospitalization (33 vs 50 admissions; 39.7 vs 59.6 hospitalizations/100 person-years; RR, 0.67; 95% CI, 0.32-1.40), bacteriuria associated with multidrug-resistant gram-negative bacilli (9 vs 24 episodes; 10.8 vs 28.6 episodes/100 person-years; RR, 0.38; 95% CI, 0.10-1.46), antibiotics administered for suspected UTIs (692 vs 909 antibiotic days; 8.3 vs 10.8 antibiotic days/person-year; RR, 0.77; 95% CI, 0.44-1.33), or total antimicrobial utilization (1415 vs 1883 antimicrobial days; 17.0 vs 22.4 antimicrobial days/person-year; RR, 0.76; 95% CI, 0.46-1.25). Among older women residing in nursing homes, administration of cranberry capsules vs placebo resulted in no significant difference in presence of bacteriuria plus pyuria over 1 year. clinicaltrials.gov Identifier: NCT01691430. |
X Demographics
The data shown below were collected from the profiles of 677 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 108 | 16% |
| Spain | 57 | 8% |
| France | 30 | 4% |
| United Kingdom | 30 | 4% |
| Canada | 22 | 3% |
| Colombia | 15 | 2% |
| Ecuador | 8 | 1% |
| Venezuela, Bolivarian Republic of | 7 | 1% |
| Ireland | 7 | 1% |
| Other | 100 | 15% |
| Unknown | 293 | 43% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 454 | 67% |
| Practitioners (doctors, other healthcare professionals) | 124 | 18% |
| Scientists | 79 | 12% |
| Science communicators (journalists, bloggers, editors) | 20 | 3% |
Mendeley readers
The data shown below were compiled from readership statistics for 280 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Japan | 1 | <1% |
| Spain | 1 | <1% |
| United States | 1 | <1% |
| Canada | 1 | <1% |
| Unknown | 276 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 37 | 13% |
| Researcher | 31 | 11% |
| Other | 28 | 10% |
| Student > Ph. D. Student | 26 | 9% |
| Student > Bachelor | 19 | 7% |
| Other | 67 | 24% |
| Unknown | 72 | 26% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 107 | 38% |
| Nursing and Health Professions | 21 | 8% |
| Agricultural and Biological Sciences | 15 | 5% |
| Immunology and Microbiology | 12 | 4% |
| Pharmacology, Toxicology and Pharmaceutical Science | 12 | 4% |
| Other | 35 | 13% |
| Unknown | 78 | 28% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1518. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 April 2024.
All research outputs
#7,833
of 25,793,330 outputs
Outputs from JAMA: Journal of the American Medical Association
#229
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Outputs of similar age
#106
of 320,261 outputs
Outputs of similar age from JAMA: Journal of the American Medical Association
#4
of 406 outputs
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So far Altmetric has tracked 36,825 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 72.3. This one has done particularly well, scoring higher than 99% of its peers.
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