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Comment & Response
March 14, 2017

Cranberry Capsules for bacteriuria Plus Pyuria in Nursing Home Residents—Reply

Author Affiliations
  • 1Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut
  • 2Section of Geriatrics, Yale School of Medicine, New Haven, Connecticut
  • 3Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, Connecticut
JAMA. 2017;317(10):1078-1079. doi:10.1001/jama.2017.0092

In Reply Ms Anderson and colleagues raise 3 main concerns about our clinical trial: (1) the study was not conducted among a group of nursing home women with a history of recurrent UTIs; (2) the sample size was small with a significant number of withdrawals and missing data, leading to wide confidence intervals around the effect of cranberry capsules; and (3) the effectiveness of cranberry capsules could logistically be tested in younger women more easily.

First, in our pilot study that tested the optimal dose of cranberry capsules, we limited recruitment to women with a history of UTIs. To enroll 80 women for 1 month of follow-up, we screened 1929 residents in 11 nursing homes, 665 were excluded because they had no history of UTIs, and the baseline rate of bacteriuria plus pyuria was 52%.1 In this study, to more efficiently recruit participants and because the primary outcome was bacteriuria plus pyuria, not UTI, we decided to remove history of recurrent UTI as an eligibility criterion.