Preventing recurrent urinary tract infection (RUTI) in children usually involves antibiotic prophylaxis. A new meta-analysis in Pediatrics of 23 randomized controlled trials found that for children with a history of RUTI, the antibiotic nitrofurantoin and cranberry products— both cranberry juice and tablets as supplementation—appeared to decrease the incidence of symptomatic episodes. Nitrofurantoin significantly lowering odds of symptomatic UTI episodes during prophylaxis, whether compared with controls (odds ratio [OR] 0.21, 95% confidence interval [CI] 0.07-0.65, P=0.007) or compared with either trimethoprim or sulfamethoxazole antibiotics (OR 0.29, 95% CI 0.10-0.82, P=0.02) or trimethoprim alone (OR 0.23, 95% CI 0.08-0.66, P<0.01). As it turns out, across all interventions, cranberry products had 59% lower odds of symptomatic UTI episodes during prophylaxis compared with the control group (OR = 0.41, 95% CI = 0.23–0.74, P = .003, P-score = 0.71).
Who doesn’t love cranberry juice? It’s easy enough to get kids to drink cranberry juice, so the intervention has merit. However, authors conclude from the analysis that no prophylaxis option “can lead to a reduction of the risk of kidney scarring after RUTI.”