Cranberry for Prevention of Urinary Tract Infections in Multiple Sclerosis Patients

Bladder dysfunction occurs at some time in 70 to 90% of patients with multiple sclerosis and these patients are prone to have recurrent urinary tract infections (UTI), leading to an important morbidity. Cranberry has been traditionally used for the treatment and prevention of UTI and research suggests that its mechanism of action is preventing bacterial adherence to host cell surface membrane.

However, systematic reviews show the small sample sizes and the poor quality of available trials, determining that there is no reliable evidence of effectiveness of cranberry in UTI prophylaxis. Therefore, to assess whether cranberry is effective in reducing UTI in patients with multiple sclerosis, we have designed a randomized, double-blind, placebo-controlled trial. Efficacy will be evaluated on the time to onset of a UTI in the first year of treatment.

Inclusion criteria

• Adults aged 18 to 70, with multiple sclerosis, neurologically stable for at least 3 months
• With an EDSS score ≥ 3
• Symptomatic bladder dysfunction: frequency, urgency, dysuria, incontinence (at least one of these symptoms), needing intermittent catheterization or not
• Ambulatory at inclusion
• Able to undergo evaluation
• Informed written consent

Non-inclusion Criteria:

• Regular consumption of cranberry within 3 months before inclusion
• Symptomatic urinary tract infection at inclusion
• Chronic renal failure (creatinin clearance < 10ml/min)
• Patients with urinary permanent catheterization
• Patients with hyperuricemia and risk of uric acid lithiasis
• Patients with oral anticoagulant treatment (antivitamins K)
• Peptic ulcer
• Intolerance to cranberry and/or excipients
• Urinary tract infections antibioprophylaxis