Primary Care Physician
Dr. Orrange received her BA in Biology at the University of California, San Diego, and a Masters Degree in Health Sciences at the Johns Hopkins University School of Public Health. She received her MD from the USC Keck School of…
How to Prevent Recurring Urinary Tract Infections (UTIs): Cranberry or Antibiotic?
Posted in Urinary Inconti... by Dr. Sharon Orrange on Aug 02, 2011
The problem of recurrent urinary tract infections (UTI) in women is frustrating, uncomfortable and discouraging. Recurrent UTI is defined as more than 3 urinary tract infections in a year. Aside from some obvious tips like urinating after sexual activity, etc., we have been looking for the best ways to prevent women from getting another UTI. Taking a daily antibiotic and cranberry extract are both used and the question is: which is better?

In a large study just published in a leading medical journal a daily dose of Bactrim (trimethoprim-sulfamethoxazole) was more effective than cranberry capsules in preventing recurrent urinary tract infections (UTIs).

Premenopausal women in this study took either 1 pill of Bactrim daily vs. 500 mg of cranberry capsules twice daily. Antibiotics worked better, with women who took Bactrim having on average 1 UTI in the 12 months they were on it and women who took cranberry extract having 4 UTIs during the 12 months of taking it.

My feeling is there is no downside to taking cranberry extract and I don’t think we should discount it all together. We do have to think about resistance to antibiotics when we have someone taking a daily dose for suppression, so while there is a benefit to Bactrim in preventing UTI, there is a higher chance of developing antibiotic resistance. The benefit of Bactrim in preventing UTI is better, but must be weighed against the development of resistance.

Dr O.

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What is mannose and where do you find it? I would like to talk this over with my kidney specialist. I don't especially like being on antibiotics forever, but I can't argue with the results. My kidney function is already compromised by the hereditary illness, so every time I get a UTI, it's not just a nuisance, it is dangerous. It could lead to still further decreased kidney function and I'm not in any hurry to be on dialysis.
By madbookworm  Aug 05, 2011
When I have UTI coming on, I always resort to cranberry juice and LOTS AND LOTS of water!! The juice has to be pure cranberry juice, no other juice added. It always works for me and is better than antibiotics. Not only is the danger of superbugs with too much antibiotics but also it could kill off the good bacteria. You would have to eat a lot of yogurt to combat that problem. So I keep it simple. And it works.
By geekygranny  Aug 04, 2011
I have recurrant UTI, I am postmenoupausal, since I has chemo in my 40 ,18 years ago, O stopped taking bubble baths, I am not sexually active, I am a widow.
I get kidney stones ocassionally. I take cranberry pills and juice daily, when I stop, the initial syntoms start, they go away with cranberry many times, others I need to take antibiotics. It is very fustrating, I have been to urologists, etc.
Also now I have stress incontinence. I think the chemo I had has to do a lot with my UTI.
By deraming  Aug 04, 2011
I already have hereditary renal failure, and after a terrible bout with pyelonephritis last year, I started getting UTI's about every three weeks. They would clear up after a round of antibiotic, but would be back within 16 or 17 days at most. This went on for months. Finally, my nephrologist put me on Bactrim every OTHER day (since I am allergic to it, but at this level, I don't have a problem with it.) I haven't had a single UTI in nearly 8 months. As far as I'm concerned, it's a miracle drug.

I take cranberry capsules too, but they obviously were not preventing infections.
By madbookworm  Aug 03, 2011
Thank you for being a voice of reason. I don't like using antibiotics as a preventative measure because of the possible antibiotic resistance.

In some cases, repeated UTIs & its symptoms w/o any infections, could be Interstitial Cystitis (IC). A lot of things contribute to this disease, including foods that cause &/or irritate the bladder.

This is a very informative website
By MyTrueColors  Aug 03, 2011
I'd pick cranberry over antibiotics any day. It works differently than antibiotics and doesn't contribute to the development of resistance. The LAST thing we need is another resistant bacteria.
By ALC67  Aug 03, 2011
My wife has had frequent UTIs. She now takes mannose when she feels a UTI coming on. Each time the mannose has worked. You might consider mannose as an alternative.
By ftirman  Aug 03, 2011
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