The Dangers Of Using Antibiotics To Prevent Urinary Tract InfectionsJune 2014
By Alex Johnson
Urinary tract infections are one of the most common infections, resulting in more than 11 million visits to the doctor each year1—and most (if not all) of them get treated with antibiotics. But when used for prevention and repetitive treatments, antibiotics pose a public health concern, as their overuse has led to the rise of antibiotic-resistant superbugs.2
That’s why scientists have been working to come up with an alternative to antibiotics. They have discovered that by preventing the bacteria from sticking to the lining of the urinary tract to begin with, it’s possible to treat and prevent urinary tract infections—and as an added bonus, to reduce the overuse of antibiotics.3
Naturally, drug companies are keenly following these developments, intent on commercializing these compounds called FimH inhibitors, which prevent bacteria from sticking to the lining of the urinary tract.4
The problem is, pharmaceutical treatments targeting this mechanism of action are years away from reaching the market. And when they do finally arrive, you can bet they won’t be cheap or necessarily safe.
The good news is that you needn’t wait for FimH inhibitors to become available through your local pharmacy. Cranberry products, long known for their effectiveness in preventing urinary tract infections, already contain naturally specialized molecules that function in exactly the same way as FimH inhibitors.5 Studies show that cranberry juice and extracts inhibit bacterial binding throughout the urinary tract, stopping potential urinary tract infections before they can even begin.
A New Way To Treat And Prevent Urinary Tract Infections
The vast majority of urinary tract infections are caused by E. coli bacteria.5,6 For these bacteria to create an infection, they have to be able to stick to cells lining the bladder or urethra (the tube through which urine leaves the body).3,5,6 The E. coli strains that are the most successful at causing urinary tract infections have developed a sophisticated set of cell-surface adhesion molecules, which act like tiny grappling hooks to attach themselves to urinary tract tissue.3-5,7
Once attached, the organisms start to reproduce, which causes inflammation, and produces the typical symptoms of a urinary tract infection: burning, painful urination, and a sense of urgency to urinate. If the infection ends up in the kidneys, it can lead to fever, chills, and low back pain.1
Current medical treatment for urinary tract infections mainly involves antibiotics that destroy bacteria (or impede their reproduction).6,8 But the overuse of antibiotics has created a new crisis: antibiotic resistance.6,9 Antibiotics can’t kill every single organism in an infection, and those that survive develop resistance to the drug. As they reproduce, they give rise to new populations that are similarly resistant. It doesn’t take many generations of bacteria until widespread resistance to multiple antibiotics occurs.6,10
In short, the more antibiotics we develop, the “tougher” the germs become. Experts warn that a generation of superbugs is emerging that will be immune to any known antibiotic therapy.
That’s why it’s so important to find a way to prevent urinary tract infections before they begin—and why scientists are working hard to develop synthetic compounds that would make the bacteria incapable of sticking to urinary lining cells.4,7,8,11 Because the most important binding molecule on E. coli cells is called FimH,6,12 the bulk of drug development has focused on creating molecules that fill up the FimH binding sites, eliminating the “stickiness” of the germs.4,6,7 These drugs are referred to as FimH inhibitors.4,13
If the bacteria are unable to bind to the urinary tract lining, they will be eliminated simply by the flow of urine, long before they can set up an infection.6
Laboratory studies show that FimH inhibitors can reduce the amount of bacterial colonization in animal bladders by a factor of almost 10,000 compared with standard antibiotic treatment.6
Fortunately, you don’t have to wait for FimH inhibitors to become available in order to effectively prevent urinary tract infections. The effective characteristics of FimH inhibitors occur naturally in cranberries.14 And that means that you can have access, right now, to a safe, effective way to keep bacteria from sticking to the urinary tract—and ultimately to help prevent urinary tract infections from occurring.
Cranberries Block Bacterial Stickiness
For more than 45 years, human studies have demonstrated the effectiveness of cranberry products, especially extracts of the whole fruit, at preventing urinary tract infections. Multiple studies, for example, have shown that when people supplement with cranberry juice or extracts, their urine acquires the ability to block bacteria from attaching to cells lining the bladder, urethra, or vagina.15-20
Cranberry supplements reduce bacterial adhesion regardless of the specific bacterial strain or of bacterial antibiotic resistance.16,21 This gives cranberry products a major edge over standard antibiotic therapy.
Cranberries contain a specific group of polyphenol molecules called proanthocyanidins.21-23 Similar to FimH inhibitors, these molecules may prevent bacteria from sticking to urinary tract lining cells.24,25 While antioxidant proanthocyanidins are found in many plant-based foods, research shows that those from cranberries appear to have more significant anti-adhesion properties.26
Multiple laboratory studies have demonstrated in detail just how effective proanthocyanidins are at reducing bacterial stickiness. One study found that cranberry powder from whole berries decreased the number of bacteria sticking to cells lining the urinary tract from 6.9 to just 1.6 organisms per cell.27
Using atomic force microscopy (an electron microscope that determines forces between individual molecules), scientists were able to measure the rapid reduction in nanoscale adhesive forces between bacteria and lining cells after the addition of cranberry juice to the Petri dish.28 Cranberry treatment produced a 12.4-fold reduction in the force holding bacteria to the cells.
In another study using atomic force microscopy, scientists gave human volunteers a dose of cranberry juice, obtained urine specimens, and then applied them directly to E. coli bacterial cells in culture.29 Urine collected just two hours after cranberry juice consumption cut the bacterial stickiness to levels lower than those obtained with urine collected before the juice dose. The bacterial stickiness continued to drop over the entire eight-hour test.
This study demonstrated that cranberry juice components rapidly enter the urine, and almost immediately lead to a decrease in the stickiness of infection-causing bacteria.29
Purified proanthocayanidin from cranberries has now been shown to be effective at preventing the adherence of multi-drug resistant strains of E. coli to urinary lining cells—showing that these molecules may be effective in preventing urinary tract infections that are difficult to treat with antibiotics.30
In addition to reducing bacterial stickiness, proanthocyanidin molecules offer additional benefits beyond FimH inhibition:
Once proanthocyanidins bind to the bacterial cell surface, they reduce the amount of the sticky projections that the organisms produce.22,31
They change the actual shape and structure of the bacteria, making them less functional.22,31
There’s growing evidence that cranberry extracts reduce the adhesion of other bacterial and yeast species that are often responsible for urinary tract and other infections, giving them a considerably broader spectrum than is likely with FimH inhibitors.32-36
Proanthocyanidins impair E. coli’s swimming ability, limiting their ability to move around even prior to latching on to bladder lining cells,32 which increases the chances of eliminating the organisms from the urinary tract before they can cause an infection.
Cranberries can reduce the bacteria’s ability to form a “biofilm,” the mucous-rich scum that forms on surfaces like urinary catheters.33,34,36 This may reduce the risk of serious urinary tract infections caused by necessary medical hardware.
Unlike FimH inhibitors, cranberry extracts also contain antioxidants and anti-inflammatory molecules.15,33,37 Together, these components can reduce damage to human cells and the symptoms that result from the inflammatory reaction to the organism.37
Cranberry treatment, especially in capsules, does not have known significant drug interactions or side effects, something that’s still unknown about FimH inhibitors.21,38