Recurrent urinary tract infections (UTIs) are common in children and may lead to long-term renal complications, especially in those with vesicoureteral reflux (VUR). Concerns about antibiotic resistance and side effects of prolonged antibiotic use underscore the need for safe, non-antibiotic alternatives. This prospective, self-controlled observational study evaluated a standardized combination of cranberry extract (36 mg proanthocyanidins daily), probiotics (Lactobacillus rhamnosus and Bifidobacterium longum), and vitamin C (250 mg daily) in 39 children aged 3-16 years, including a subgroup with mild-to-moderate VUR. UTI recurrence was compared before and after the 12-month study period. The supplement was administered for 6 months, followed by a 6-month observation period. Microbiological analyses assessed pathogen distribution. Safety and tolerability were monitored. The intervention significantly reduced UTI recurrence, with median episodes decreasing from 3 to 0 in children without VUR (p p Escherichia coli remained the predominant pathogen, while the diversity of other uropathogens changed minimally, indicating fewer infections rather than microbial shifts. The supplement was well tolerated, with mild gastrointestinal symptoms in 5 of 39 participants (12.8%) and no serious adverse events. Subgroup analyses showed consistent benefit across age and sex, with children having higher baseline UTI frequency experiencing the greatest reduction. A multi-component supplement of cranberry, probiotics, and vitamin C effectively reduced recurrent pediatric UTIs, decreased overall infection burden, preserved E. coli as the main pathogen, and was safe and well tolerated, including in children with mild-to-moderate VUR.
Dotis et al. (2026) studied this question.