Christian Moro, Charlotte Phelps, Vineesha Veer, Mark Jones, Paul Glasziou, Justin Clark, Kari A O Tikkinen, Anna Mae Scott
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引用次数: 0
摘要
背景和目的：每年有 50%以上的女性至少患一次尿路感染（UTI），而抗菌药耐药性的流行率却在不断上升，因此需要努力明确支持潜在非药物干预措施的证据。本研究旨在比较蔓越莓果汁、蔓越莓片剂和增加液体治疗UTI的效果：方法：在 PubMed、Embase 和 Cochrane CENTRAL 中检索随机对照试验。主要结果为UTI数量，次要结果为UTI症状和抗菌药物消耗量。采用科克伦偏倚风险工具对偏倚风险进行了评估，并采用建议评估、制定和评价分级法对证据的确定性进行了评估：共纳入了 20 项试验（3091 名参与者），其中 18 项研究表明，饮用蔓越莓汁比不饮用蔓越莓汁的尿毒症发病率低 54%，比饮用安慰剂液体的尿毒症发病率低 27%。根据对六项研究的网络荟萃分析，蔓越莓汁还使抗生素使用率比安慰剂液体低 49%，比不治疗低 59%。使用蔓越莓化合物还能降低UTI相关症状的发生率：中度至低度确定性的证据支持使用蔓越莓汁预防 UTIs。虽然与不治疗相比，增加液体可降低 UTI 的发病率，但液态蔓越莓在减少 UTI 和抗生素使用方面可提供更好的临床效果，因此应考虑用于 UTI 的治疗。现有证据支持使用蔓越莓化合物和增加液体摄入量来治疗 UTI。
Cranberry Juice, Cranberry Tablets, or Liquid Therapies for Urinary Tract Infection: A Systematic Review and Network Meta-analysis.
Background and objective: With over 50% of women suffering from at least one episode of urinary tract infection (UTI) each year and an increasing prevalence of antimicrobial resistance, efforts need to be made to clearly identify the evidence supporting potential non-drug interventions. This study aims to compare the effects of cranberry juice, cranberry tablets, and increased liquids for the management of UTIs.
Methods: PubMed, Embase, and Cochrane CENTRAL were searched for randomised controlled trials. The primary outcome was the number of UTIs, and the secondary outcomes were UTI symptoms and antimicrobial consumption. A risk of bias assessment was performed using the Cochrane risk of bias tool, and the certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation.
Key findings and limitations: A total of 20 trials (3091 participants) were included, with 18 studies highlighting a 54% lower rate of UTIs with cranberry juice consumption than no treatment and a 27% lower rate than placebo liquid. Cranberry juice also resulted in a 49% lower rate of antibiotic use than placebo liquid and a 59% lower rate than no treatment, based on a network meta-analysis of six studies. The use of cranberry compounds also reduced the prevalence of symptoms associated with UTIs.
Conclusions and clinical implications: With moderate to low certainty, the evidence supports the use of cranberry juice for the prevention of UTIs. While increased liquids reduce the rate of UTIs compared with no treatment, cranberry in liquid form provides even better clinical outcomes in terms of reduction in UTIs and antibiotic use and should be considered for the management of UTIs.
Patient summary: With the increasing prevalence of antimicrobial-resistant UTIs, alternate non-drug treatment options for its management are required. Available evidence supports the use of cranberry compounds and increases in fluid intake for managing UTIs.
期刊介绍：
European Urology Focus is a new sister journal to European Urology and an official publication of the European Association of Urology (EAU).
EU Focus will publish original articles, opinion piece editorials and topical reviews on a wide range of urological issues such as oncology, functional urology, reconstructive urology, laparoscopy, robotic surgery, endourology, female urology, andrology, paediatric urology and sexual medicine. The editorial team welcome basic and translational research articles in the field of urological diseases. Authors may be solicited by the Editor directly. All submitted manuscripts will be peer-reviewed by a panel of experts before being considered for publication.
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