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Halt the Vicious Cycle of Urinary Tract Infections

Novel Next-Generation Antimicrobial Protection

April 2010

By Victoria Dolby Toews, MPH

A Potent New UTI Intervention

A Potent New UTI Intervention

Native to Africa and Asia, Hibiscus sabdariffa has been used in some cultures to support bladder and kidney health. Traditional African practitioners use tea brewed from hibiscus calyxes (the green floral envelope of the blossom) as an acidic and anti-bacterial, both to acidify and deodorize urine and protect against UTIs and kidney stone formation.

Hibiscus boasts a range of powerful compounds that prevent E. coli from adhering to the urinary tract and bladder wall linings. Both the flower and calyx are abundant in bacteriostatic polyphenols, including flavonoids, sambubiosides, and proanthocyanidins. In particular, the flavonoid gossypetin (3,5,7,8,3,’ 4’-hexahydroxy flavone) found in hibiscus has been identified as a distinct antimicrobial compound with powerful effects.3 Together these natural agents have been shown to inhibit the activity of a host of microbes responsible for UTIs, including E. coli, Staphylococcus aureus, and Pseudomonas aeruginosa. In fact, hibiscus’s mode of prophylaxis (prevention) and high concentration of bacteriostatic compounds may exert bacteriocidal (bacteria-killing) effects comparable to the antibiotic chloramphenicol—with none of the risks.

In a double-blind, placebo-controlled, clinical trial, women taking hibiscus experienced a 77% reduction in UTIs.6 Sixty-one women participated in the 6-month study, and 59 women completed the entire study. All of them had a history of frequent UTIs (more than four per year, including one or more in the three months prior to the start of the study). The women were randomly assigned to one of three groups receiving a daily dose of 200 mg of hibiscus extract standardized to 90% polyphenols; 200 mg of hibiscus extract standardized to 60% polyphenols; or placebo. Compared to the control group, women taking the hibiscus concentrations experienced a 77% decrease in infections, as well as overall improvement in urinary comfort.

In 2009, a group of researchers compared antibiotics head-to-head with daily supplements of cranberry extract in women suffering from recurrent infection.16 Cranberry (500 mg) and antibiotics (100 mg trimethoprin) were shown to be almost equally effective in preventing UTIs.

According to in vitro research, hibiscus also reduces contamination of both E. coli and Candida albicans, the fungus responsible for yeast infections.3,17,18 The antimicrobial effect was found to be immediate and complete after only one day. In addition, when hibiscus was compared to cranberry in vitro, the hibiscus had a stronger antimicrobial effect, particularly against Candida albicans.19

Hibiscus’s bacteriostatic/bacteriocidal compounds are excreted through urine in high concentrations, enabling them to reach the bladder and urinary tract intact, where they disable infectious bacteria.20



Urinary tract infections (UTIs) are the most common form of bacterial infection, accounting for 7 million office visits, 1 million emergency room visits, and 100,000 hospitalizations each year, with an estimated cost of $1.6 billion annually. One third of all women will contract a UTI by the age of 24. Once a woman has contracted a UTI, her risk of recurrence is 20%.

The proanthocyanidins in cranberry effectively prevent UTIs by blocking E. coli from adhering to the urinary tract and bladder. Cranberry is especially effective for women who endure numerous UTIs annually. Studies show that cranberry extract in pill form is more economical than drinking large quantities of 100% cranberry juice.

Like cranberry, extract of Hibiscus sabdariffa prevents bacteria that cause UTIs from adhering to the linings of the urinary tract and bladder wall and may also possess bacteriocidal effects. Abundant in polyphenolic compounds, hibiscus may exhibit bacteriocidal (bacteria-killing) properties comparable to the antibiotic chloramphenicol—without the antibiotic’s side effect profile. When compared to cranberry in vitro, hibiscus had a stronger antimicrobial effect, particularly against Candida albicans.

If you have any questions on the scientific content of this article, please call a Life Extension® Health Advisor at 1-866-864-3027.

Victoria Dolby Toews, MPH has been a health journalist since 1993; her latest book is The Green Tea Book, second edition (Penguin, 2007).


1. Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Am J Med. 2002 Jul 8;113 Suppl 1A:5S-13S.

2. Available at: Accessed January 18, 2010.

3. Mounnissamy VM, Kavimani S, Gunasegaran R. Antibacterial activity of gossypetin isolated from hibiscus sabdariffa. The Antiseptic. 2002 Mar; 99(3): 81-2.

4. Hess MJ, Hess PE, Sullivan MR, Nee M, Yalla SV. Evaluation of cranberry tablets for the prevention of urinary tract infections in spinal cord injured patients with neurogenic bladder. Spinal Cord. 2008 Sep;46(9):622–6.

5. Bailey DT, Dalton C, Joseph Daugherty F, et al. Can a concentrated cranberry extract prevent recurrent urinary tract infections in women? A pilot study. Phytomedicine 2007;14(4):237-41.

6. Allaert F. Double-blind, placebo-controlled study of Hibiscus sabdariffa L extract in the prevention of recurrent cystitis in women. Poster presented at the Federative Pelviperineal Diagnostics and Procedures Meeting: Convergences in Pelviperineal Pain. Nantes, France: December 16-18, 2009.

7. Pinzón-Arango PA, Liu Y, Camesano TA. Role of cranberry on bacterial adhesion forces and implications for Escherichia coli-uroepithelial cell attachment. J Med Food. 2009 Apr;12(2):259-70.

8. Jass J, Reid G. Effect of cranberry drink on bacterial adhesion in vitro and vaginal microbiota in healthy females. Can J Urol. 2009 Dec;16(6):4901-7.

9. Lee YL, Owens J, Thrupp L, Cesario TC. Does cranberry juice have antibacterial activity? JAMA. 2000 Apr 5;283(13):1691.

10. Howell MB. Bioactive compounds in cranberries and their role in prevention of urinary tract infections. Mol Nutr Food Res. 2007 Jun;51(6):732-7.

11. Stothers L. A randomized placebo controlled trial to evaluate naturopathic cranberry products as prophylaxis against urinary tract infection in women. Presented at: American Urological Association 2001 Annual Meeting; June 2-7, 2001; Anaheim, CA; Publ ID:318.

12. Kontiokari T, Sundqvist K, Nuutinen M, et al. Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women. BMJ. 2001 Jun 30;322(7302):1571.

13. Ferrara P, Romaniello L, Vitelli O, et al. Cranberry juice for the prevention of recurrent urinary tract infections: a randomized controlled trial in children. Scand J Urol Nephrol. 2009;43(5):369-72.

14. Stothers L. A randomized trial to evaluate effectiveness and cost effectiveness of naturopathic cranberry products as prophylaxis against urinary tract infection in women. Can J Urol. 2002 Jun;9(3):1558-62.

15. Avorn J, Monane M, Gurwitz JH, Glynn RJ, Choodnovskiy I, Lipsitz LA. Reduction of bacteriuria and pyuria after ingestion of cranberry juice. JAMA. 1994 Mar 9;27(10):751-4.

16. McMurdo ME, Argo I, Phillips G, Daly F, Davey P. Cranberry or trimethoprim for the prevention of recurrent urinary tract infections? A randomized controlled trial in older women. J Antimicrob Chemother. 2009 Feb;63(2):389-95.

17. Ali BH, Al Wabel N, Blunden G. Phytochemical, pharmacological and toxicological aspects of Hibiscus sabdariffa L.: a review. Phytother Res. 2005 May;19(5):369-75.

18. Rukayadi Y, Shim JS, Hwang JK. Screening of Thai medicinal plants for anticandidal activity. Mycoses. 2008 Jul;51(4):308-12.

19. Burgundy Botanical Extracts. Data on file.

20. Frank T, Janssen M, Netzel M, et al. Pharmacokinetics of anthocyanidin-3-glycosides following consumption of Hibiscus sabdariffa L. extract. J Clin Pharmacol. 2005 Feb;45(2):203-10.