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Antimicrobial Agents and Chemotherapy, July 2009, p. 2725-2732, Vol. 53, No. 7
0066-4804/09/$08.00+0     doi:10.1128/AAC.00774-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Effects of Cranberry Juice on Pharmacokinetics of β-Lactam Antibiotics following Oral Administration{triangledown}

Meng Li,1 Marilee A. Andrew,2,3 Joanne Wang,1 David H. Salinger,2 Paolo Vicini,2 Richard W. Grady,4 Brian Phillips,5 Danny D. Shen,1,5,6 and Gail D. Anderson6*

Department of Pharmaceutics,1 Department of Bioengineering,2 Applied Physics Laboratory, University of Washington, Seattle, Washington 98105,3 Department of Urology, School of Medicine, University of Washington, Seattle, Washington 98195,4 Pharmacokinetics Laboratory, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109,5 Department of Pharmacy, University of Washington, Seattle, Washington 981956

Received 13 June 2008/ Returned for modification 16 October 2008/ Accepted 19 April 2009

Cranberry juice consumption is often recommended along with low-dose oral antibiotics for prophylaxis for recurrent urinary tract infection (UTI). Because multiple membrane transporters are involved in the intestinal absorption and renal excretion of β-lactam antibiotics, we evaluated the potential risk of pharmacokinetic interactions between cranberry juice and the β-lactams amoxicillin (amoxicilline) and cefaclor. The amoxicillin-cranberry juice interaction was investigated in 18 healthy women who received on four separate occasions a single oral test dose of amoxicillin at 500 mg and 2 g with or without cranberry juice cocktail (8 oz) according to a crossover design. A parallel cefaclor-cranberry juice interaction study was also conducted in which 500 mg cefaclor was administered with or without cranberry juice cocktail (12 oz). Data were analyzed by noncompartmental methods and nonlinear mixed-effects compartmental modeling. We conclude that the concurrent use of cranberry juice has no significant effect on the extent of oral absorption or the renal clearance of amoxicillin and cefaclor. However, delays in the absorption of amoxicillin and cefaclor were observed. These results suggest that the use of cranberry juice at usual quantities as prophylaxis for UTI is not likely to alter the pharmacokinetics of these two oral antibiotics.

* Corresponding author. Mailing address: Department of Pharmacy, Health Science Complex H-361A, University of Washington, Box 357630, Seattle, WA 98195. Phone: (206) 685-1864. Fax: (206) 543-3835. E-mail: gaila{at}u.washington.edu

{triangledown} Published ahead of print on 27 April 2009.

Antimicrobial Agents and Chemotherapy, July 2009, p. 2725-2732, Vol. 53, No. 7
0066-4804/09/$08.00+0     doi:10.1128/AAC.00774-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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