The Onion Becomes Reality for UTI Prevention

The Onion Becomes Reality for UTI Prevention

There was a classic Onion article from 1999 entitled Revolutionary New Insoles Combine Five Forms Of Pseudoscience.

The magic of alternative medicine is what starts as parody on a humor website becomes reality in the medical literature. I give you Effectiveness of a Combination of Cranberries, Lactobacillus rhamnosus, and Vitamin C for the Management of Recurrent Urinary Tract Infections in Women: Results of a Pilot Study.

Take three therapies that do not prevent urinary tract infections.

  • Cranberries: " Although some of small studies demonstrated a small benefit for women with recurrent UTIs, there were no statistically significant differences when the results of a much larger study were included."
  • Lactobacillus. And not any Lactobacillus. Killed Lactobacillus. So you would not even get a potential probiotic effect.
  • Vitamin C.

As the authors note "they are ineffective as single agents in most cases."

So why not combine them for "their potential synergistic effect"?

Why indeed? Prior plausibly would make any positive a likely false positive.

Synergy, at least in infectious diseases, is where the effect of combining antibiotics is greater than the effect of the drugs when used alone. Sort of 1 + 1 = 3.

In this case they hypothesize that 0 + 0 + 0 = something. Was it?

They showed

Overall, 26 (72.2%) and 22 patients (61.1%) were responders at the 3-mo and 6-month follow-up.

These rates are about the same as the natural history of recurrent uti's, a disease whose "episodes (are) strikingly clustered"

Realizing that the study is small, no placebo, is not blinded, not randomized and has a high dropout rate saying the combination of three forms of worthless therapies (emphasis added)

might represent a safe and effective option.

is vastly overstating the case.

It is a pilot study. It is just not a pilot that I want flying my plane.

Points of Interest 07/09/2016
Points of Interest 07/05/2016

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