Introduction

Name

• Cranberry proanthocyanidins (PACs).

Class of drug

• Nutraceutical.
• Polyphenol.
• Condensed tannin.
• Bacterial anti-adhesion.

Description

Chemical name

• A-linked proanthocyanidin.

Molecular formula

• C31H28O12.

Physical properties

• Brown powder.

Storage requirements

• Store in a dry place <25°C.
• Keep container tightly closed.

Processing

• The A-linked PACs found in cranberries are sensitive to destruction or inactivation during cranberry processing into the finished raw material, especially if temperatures above 40°C are used in the extraction process. As a result, the bioactivity of cranberry-containing products can be highly variable.
• The bioactivity of each batch of finished product should be confirmed using a bacterial anti-adhesion bioassay to assure efficacy of the PACs.
• Efficacious PAC levels in cranberry products need to be confirmed using a standardized quantification method, such as DMAC. Otherwise PAC levels can be over- or under-estimated.

Uses

Indications

• A nutritional aid in the management of urinary health/prevention of UTIs Cranberry extract containing proanthocyanidins for urinary health.
• Consider in cases of chronic or recurrent UTIs Cystitis due to:
  • Anatomical defects in the patient (eg recessed vulva, ectopic ureters Ureter: ectopic ).
  • Diabetes Diabetes mellitus.
  • Renal disease Kidney: chronic kidney disease (CKD).
  • Cushing's Hyperadrenocorticism.
  • Neoplasia.
  • Presence of indwelling urinary catheter (such as in an IVDD patient).
• Anti-adhesion effect for bacteria within the urinary tract.
• Can be used concurrently with antibiotics when treating UTIs:
  • Research indicates no interactions between cranberry products containing PACs and beta-lactam antibiotics.

Administration

Pharmacokinetics

Precautions

Interactions

with other drugs

• Often used with antibiotics Therapeutics: antimicrobial drug , and no interactions have been reported.

Adverse Reactions

Further Reading

Publications

Refereed papers

• Recent references from PubMed and VetMedResource.
• Howell A B, Botto H, Combescure C et al (2010) Dosage effect on uropathogenic Escherichia coli anti-adhesion activity in urine following consumption of cranberry powder standardized for proanthocyanidin content: a multicentric randomized double blind study. BMC Infect Dis 10, 94 PubMed.
• Tufenkji N, Rifai O J, Harmidy K et al (2010) Cranberry derived proanthocyanidins can prevent pathogen invasion of kidney epithelial cells. Food Research International 43 (3), 922-924 VetMedResource.
• Li M, Andrew M A, Wang J et al (2009) Effects of cranberry juice on pharmacokinetics of beta-lactam antibiotics following oral administration. Antimicrob Agents Chemother 53 (7), 2725-2732 PubMed.
• Eydelnant I A & Tufenkji N (2008) Cranberry derived proanthocyanidins reduce bacterial adhesion to selected biomaterials. Langmuir 24 (18), 10273-10281 PubMed.
• Bubenik L J, Hosgood G L, Waldron D R et al (2007) Frequency of urinary tract infection in catheterized dogs and comparison of bacterial culture and susceptibility testing results for catheterized and noncatheterized dogs with urinary tract infections. J Am Vet Med Assoc 231 (6), 893-899 PubMed.
• Howell A B (2007) Bioactive compounds in cranberries and their role in prevention of urinary tract infections. Mol Nutr Food Res 51 (6), 732-737 PubMed.
• Ogeer-Gyles J, Mathews K, Weese J S et al (2006) Evaluation of catheter-associated urinary tract infections and multidrug-resistant Escherichia coli isolates from the urine of dogs with indwelling urinary catheters. J Am Vet Med Assoc 229 (10), 1584-1590 PubMed.
• Howell A B, Reed J D, Krueger C G et al (2005) A-type cranberry proanthocyanidins and uropathogenic bacterial anti-adhesion activity. Phytochemistry 66 (18), 2281-2291 PubMed.
• Foo L Y, Lu Y, Howell A B et al (2000) A-Type proanthocyanidin trimers from cranberry that inhibit adherence of uropathogenic P-fimbriated Escherichia coli. J Nat Prod 63 (9), 1225-1228 PubMed.
• Avorn J, Monane M, Gurwitz J H et al (1994) Reduction of bacteriuria and pyuria after ingestion of cranberry juice. JAMA 271 (10), 751-754 PubMed.

Other sources of information

• Howell A & Bartges J (2010) Clinical notes: Benefits of cranberry extracts for management of UTI. NAVC Clinicians Brief May, 49-50.
• Howell A B, Griffin D W & Whalen M O (2010) Inhibition of P-fimbriated Escherichia coli adhesion in an innovational ex-vivo model in dogs receiving a bioactive cranberry tablet (Crananidin"). J Vet Intern Med 24 (3), 678.