The headline, sadly, missed the point of the story – which praised cranberries for avoiding creating antibiotic-resistant bacteria. This short story raises some confusing questions about the risk vs. benefits for women who seek a way to prevent urinary tract infections. But the topic’s complexity is not easily stuffed into a change-purse sized story.
The story also mixes in treatment with prevention. Additionally, it does not point out that only women with frequent infections are candidates for preventive doses of antibiotics.
American women and health insurers spend more than $1 billion each year on urinary tract infections, according to a 2005 report by the University of Michigan. This is from an estimated 7 million office visits.
The choice of any antibiotic, and the way patients interact with primary physicians, can have enormous impact on our society’s costs and each patient’s health. Ineffective treatment at the beginning of symptoms may lead to repeated courses of antibiotics, and this is a drain on both the patient and society. Likewise, the issue of resistant bacteria from ineffective or overuse of antibiotics is also a threat to the community.
This story raises complex questions but does not give us conclusive evidence or provide analysis of the one small study being reported.
The story does not discuss costs and does not examine the relative price of different avenues for urinary health and prevention of infections by women. An important element of cost for these regimens is that women choosing cranberry extract can do so without a physician visit or prescription. Antiobiotics require both of those, with the associated costs (high).
The story’s discussion of benefit was confusing. The headline says “antibiotics beat cranberries” but the lead sentence states that cranberry treatment may be “the best approach” for a woman worried about antibiotic-resistant bacteria.
It’s good that the story included the absolute rates (4% vs. 1.8%) and we already know the number in each group. The story should have noted that there was no placebo group. We don’t know if cranberry prevented UTI, because we don’t know the baseline rate in the population (the study was probably too small to pick up modest differences anyway).
Because of the awkward and confusing beginning, we give this an unsatisfactory score.
This short story does raise one potential harm – what happens if women interpret this research to mean they should dose themselves with cranberry and fail to report symptoms to their doctors?
However, we aren’t thrilled with the inadequate overall discussion. One could check Medlineplus as a source of additional harm of any supplements. There is a possible increased risk of kidney stones and medication interaction with the anticoagulant coumadin.
The story barely meets this standard. It does give us the small number of patients in this research study (221 women) and it does give some data about the resistant bacteria samples taken from each arm of patients. We would have liked to see an outside expert address the quality of the study itself.
This story avoids exaggerating the discomfort or dangers of urinary tract infections.
The story appears to use one independent source.
We aren’t given much context about urinary infections, in general, and how they are routinely prevented vs. what this research suggests might be an alternative. Two common methods for prevention include drinking plenty of water and frequently emptying the bladder.
The story discussed cranberry capsule supplements, but never discussed their availability. Maybe that’s common knowledge to some folks, but not to all. We’ll rule it Not Applicable.
There is nothing novel about cranberry capsules, and the story makes no such claim.
The story does not appear to rely on a single source.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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