The diameter, length, and shape of bacteria are maintained with such high fidelity that these parameters are classically used as metrics in the distinction of bacterial species. Increasing evidence indicates that bacteria transiently shift their shapes into distinctive morphologies in response to environmental changes. Elongation of bacterial length into a filamentous shape provides unique survival advantages for many bacterial species. Analysis of 42 clinical isolates of uropathogenic Escherichia coli (UPEC) revealed that filamentation to host-derived antimicrobials is a conserved phenotype. Therefore, we hypothesize that filamentation represents a conserved mechanism of pathogenic bacterial persistence that can be targeted for narrow-spectrum, anti-virulence therapies. We demonstrate that cranberries prevent SulA-mediated filamentation of UPEC. Furthermore, we identify multiple fractions of cranberries that retain anti-filamentation properties. These studies provide mechanistic insight into the clinical efficacy of cranberry for patients with recurrent urinary tract infections. Inhibition of filamentation represents a novel approach to promote bacterial pathogen susceptibility to immune and antibiotic-mediated clearance to attenuate disease.

Objective: Urinary tract infections (UTIs) rank as the second most prevalent infectious condition globally, impacting approximately 150 million individuals each year. Due to anatomical and physiological changes, UTIs are particularly common during pregnancy, presenting with symptoms such as dysuria, turbid urine, increased urinary frequency, and occasionally hematuria. Recurrent UTIs are characterized by two or more episodes within six months or three within a year. Cranberries are widely acknowledged for their role in preventing UTIs during pregnancy. Their preventive mechanism involves inhibiting uropathogenic bacterial adhesion to the urinary tract epithelium, facilitated by phenolic compounds and A-type proanthocyanidins (PACs). 

Materials and Methods: In this systematic review, the authors PubMed, ScienceDirect, ResearchGate, and Google Scholar for relevant articles published between 2013 and 2024. The search strategy utilized Medical Subject Headings (MeSH) and keyword terms related to Cranberry Extract/Juice and UTI Measurement Methods in Pregnancy. Search phrases were tailored to each database to enhance retrieval accuracy. All retrieved articles were evaluated in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. 

Results: Among the 30 studies reviewed, a daily dose of 500 mg cranberry extract over six months demonstrated promising efficacy as an alternative treatment for UTIs in pregnancy. 

Conclusion: Cranberry (Vaccinium macrocarpon) extract effectively prevents UTIs by inhibiting bacterial adhesion and exerting antibacterial effects. This review confirms cranberry as a promising, safe alternative for UTI treatment and prevention in pregnancy, suitable for daily consumption

Introduction: Urinary tract infections (UTIs) are a global health concern, increasingly complicated by antibiotic resistance. Cranberry-derived bioactive compounds, particularly proanthocyanidins (PACs), have emerged as a promising non-antibiotic strategy for UTI prevention. This review examines their efficacy, mechanisms of action, and the evolving research landscape through bibliometric analysis. 

Methods: A comprehensive literature review was conducted to assess the role of cranberry metabolites in UTI prevention, focusing on anti-adhesive and antimicrobial mechanisms. Additionally, a bibliometric analysis of publications from 1962 to 2024 was performed to evaluate research trends, collaboration networks, and thematic developments. 

Results: Cranberry metabolites, particularly A-type PACs, flavonoids, and phenolic acids, inhibit Escherichia coli adhesion to urothelial cells, reducing UTI recurrence. Gut microbiota-driven transformation of PACs into bioactive metabolites enhances their efficacy, while cranberry oligosaccharides disrupt biofilm formation in high-risk populations. Bibliometric analysis reveals a surge in research interest post-2000, with increasing global collaborations and a focus on clinical applications. 

Discussion and conclusion: Cranberry bioactives demonstrate significant potential in UTI management, yet variations in formulation, dosage, and metabolic bioavailability present challenges. The growing research interest underscores the need for standardized clinical studies to optimize therapeutic efficacy and establish evidence-based guidelines for their use.

Urolithiasis (UL) is a multifactorial condition whose global prevalence has been increasing in recent years, and it is closely associated with dietary factors. Diet is one of the key elements linked to the development of UL, due to the intake of many nutrients that cause metabolic alterations associated with the crystallization process and the risk of developing urinary stones. Despite the crucial role of diet, few studies have implemented dietary interventions. In this sense, dietary modifications play a fundamental role in the prevention, control and management of UL. Thus, the aim of this systematic review is to summarize the main beneficial effects of dietary interventions in population with UL. A comprehensive search was conducted in MEDLINE/PubMed, SpringerLink, Google Scholar, Scielo, and Redalyc databases for intervention studies published up to July 2025, which reported dietary interventions aimed at preventing and controlling UL. The risk of bias and quality of studies were assessed. A total of 26 articles were included, focusing on dietary interventions such as controlling sodium, oxalate, calcium, citrate, and protein intake, as well as low-calorie diets. Additionally, foods such as lemon, orange, melon, lime, cranberry, apple juices, milk, vinegar, black seed, green bean extract, probiotics, and synbiotic were also explored, which promoted significant changes in serum and urinary parameters related to UL. This review compiles evidence on dietary intervention strategies that lead to significant improvements in biochemical parameters in populations with UL (PROSPERO CRD42022361702).

Background: Recurrent urinary tract infections (UTIs) are a common clinical problem among premenopausal women, often managed with prophylactic antibiotics that contribute to antimicrobial resistance. Cranberry extract, rich in proanthocyanidins, has emerged as a promising non-antibiotic alternative for UTI prevention, though existing evidence remains inconsistent due to variability in study designs and formulations. 

Objective: To evaluate the effectiveness of standardized cranberry extract supplementation in reducing recurrence rates of urinary tract infections in premenopausal women. 

Methods: This double-blind, randomized controlled trial was conducted over ten months in tertiary care hospitals in Lahore, Pakistan. A total of 160 premenopausal women with a history of recurrent UTIs were enrolled and randomly assigned to receive either 500 mg cranberry extract standardized to 36 mg PACs or placebo once daily for six months. Primary outcomes included the mean number of recurrent UTI episodes and time to first recurrence. Secondary outcomes assessed antibiotic use, adherence, and patient satisfaction. Data were analyzed using independent t-tests, Kaplan-Meier survival analysis, and chi-square tests, with significance set at p<0.05. 

Results: The cranberry group reported a significantly lower mean number of UTI episodes (0.6 vs. 1.2), longer time to first recurrence (142.3 vs. 97.6 days), and reduced antibiotic use (0.7 vs. 1.4 courses) compared to placebo. Recurrence occurred in 27.5% of the cranberry group versus 57.5% in placebo. Adherence exceeded 90% in both groups, with higher satisfaction in the cranberry arm. No serious adverse events were reported. Conclusion: Cranberry extract supplementation effectively reduced UTI recurrence and antibiotic dependence among premenopausal women. These findings support its role as a safe, non-antibiotic preventive strategy.

Following an application from Givaudan, submitted for authorisation of a health claim pursuant to Article 13(5) of Regulation (EC) No 1924/2006 via the Competent Authority of Italy, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on the scientific substantiation of a health claim related to Pacran® and defence against bacterial pathogens in the lower urinary tract. The Panel considers that the food Pacran®, a powder obtained from cranberries, is sufficiently characterised. Defence against bacterial pathogens in the lower urinary tract is a beneficial physiological effect. The applicant identified two human intervention studies which investigated the effect of Pacran® on the incidence of urinary tract infections (UTI) as being pertinent to the claim. In weighing the evidence, the Panel took into account that one human intervention study showed a beneficial effect of Pacran® consumed daily at doses of 500 mg for 6 months on the incidence of symptomatic, culture-confirmed UTI in women with a history of recurrent UTI, whereas such an effect was not consistently observed in another study under similar conditions. The Panel also took into account that limited evidence has been provided for a mechanism by which Pacran® could exert the claimed effect. The Panel concludes that the evidence provided is insufficient to establish a cause and effect relationship between the consumption of Pacran® and the defence against bacterial pathogens in the lower urinary tract.

Urinary tract infections (UTIs) are among the most prevalent bacterial infections in women, with high recurrence rates and growing concerns over antimicrobial resistance. The need for alternative or adjunctive therapies has spurred interest in plant-based treatments, which offer antimicrobial, anti-inflammatory, antioxidant, and immune-modulatory benefits. This review summarizes the mechanisms of action, clinical efficacy, and therapeutic potential of various medicinal plants and natural compounds for preventing and treating UTIs in women. Notable candidates include cranberry, bearberry, pomegranate, green tea, and other phytochemicals with proven anti-adhesive and biofilm-disrupting properties. Evidence from clinical trials and meta-analyses supports the role of cranberry natural products and traditional herbal medicines (THMs) in reducing UTI recurrence, especially when combined with antibiotics. Notably, A-type proanthocyanidins in cranberry and arbutin in bearberry are key bioactive compounds that exhibit potent anti-adhesive and biofilm-disrupting properties, offering promising adjunctive strategies for preventing recurrent urinary tract infections. Additionally, emerging therapies, such as platelet-rich plasma (PRP), show promise in restoring bladder function and reducing infection in women with lower urinary tract dysfunction. Overall, plant-based strategies represent a valuable and well-tolerated complement to conventional therapies and warrant further investigation through high-quality clinical trials to validate their efficacy, safety, and role in personalized UTI management.

Recurrent urinary tract infection (rUTI) is a significant public health problem in women. General measures to prevent recurrence include behavioral changes and increased fluid intake, cranberry ingest, use of methenamine hippurate, antibiotic prophylaxis, D-mannose, probiotics, or vaccines. We conducted a literature review of the latest updates on preventing rUTI in December 2024. The search concluded with 27 articles that fulfilled our inclusion criteria. Our review demonstrated that behavioral changes such as correct genital hygiene, avoiding postponing micturition or defecation, urinating after sexual intercourse, and ingesting 1.5-2 L of water could prevent rUTI. The ingestion of cranberries reduces the risk of symptomatic, culture-verified urinary tract infections in women with rUTIs. Methenamine hippurate is an alternative to antibiotics to avoid rUTI. Estrogen reduces rUTI in women with hypoestrogenism. Limited evidence supports using D-mannose, probiotics, and vaccines to prevent rUTI. In conclusion, after successful treatment of the acute episode, preventative measures are needed to reduce rUTI frequency and morbidity according to each patient's characteristics and preferences

Background: High prevalence of urinary tract infections (UTI), including cystitis, and concern for antimicrobial resistance justify safe and effective nonantibiotic therapies for prevention of recurrent UTI (rUTI). Objectives: This study investigated the effect of a whole cranberry fruit powder supplement on incidence of culture-confirmed UTI (primary outcome) in females with rUTI history.

Methods: This multicenter, 6-mo, randomized, placebo-controlled, double-blind study enrolled 150 healthy females [18-65 y, body mass index (BMI) >17.5 and <35 kg/m2] with rUTI defined as >=3 UTIs in the last year or <=2 UTIs in the last 6 mo, excluding those with >5 UTIs in the last 6 mo. Participants consumed either 1 capsule of 500 mg/d of whole cranberry powder (Pacran) or placebo. Culture-confirmed UTIs (>108cfu/L) were assessed throughout the intervention period at unscheduled clinic visits whenever participants experienced UTI symptoms and at baseline, 3- and 6-mo clinic visits. Symptomatic suspected UTIs were defined as participant-reported UTI-associated symptoms at unscheduled visits. 

Results: Whole cranberry powder capsules reduced culture-confirmed UTI risk compared with placebo by 52% (adjusted relative risk [RR]: 0.48; 95% confidence interval [CI]: 0.26, 0.87; P = 0.01); reduced Escherichia coli UTIs (RR: 0.49; 95% CI: 0.24, 1.01; P = 0.05); reduced incidence of UTI with urinary frequency and urgency symptomatology (RR: 0.29; 95% CI:0.13, 0.63; P < 0.01); delayed time to first UTI episode (adjusted hazard ratio [HR]: 0.36; 95% CI: 0.18, 0.74; P = 0.01); and reduced the mean total number of UTIs per participant (adjusted incidence rate ratio IRR: 0.41; 95% CI: 0.21, 0.79; P = 0.01). Significant differences between groups in incidence of symptomatic suspected UTIs and culture-confirmed dysuria were not observed. Exploratory scores for UTI-related female sexual matters, assessed in a subset of sexually active, consenting females, did not differ significantly between groups. No safety concerns were reported. 

Conclusion: This study shows that whole cranberry powder capsules do not impact safety markers and reduce the incidence of culture-confirmed UTI and several other UTI-related outcomes in healthy females with rUTI history. This trial was registered at clinicaltrials.gov asNCT03042273.

Background High prevalence of urinary tract infections (UTI), including cystitis, and concern for antimicrobial resistance justify safe and effective nonantibiotic therapies for prevention of recurrent UTI (rUTI). 

Objectives This study investigated the effect of a whole cranberry fruit powder supplement on incidence of culture-confirmed UTI (primary outcome) in females with rUTI history. 

Methods This multicenter, 6-mo, randomized, placebo-controlled, double-blind study enrolled 150 healthy females [18–65 y, body mass index (BMI) >17.5 and <35 kg/m2] with rUTI defined as ≥3 UTIs in the last year or ≤2 UTIs in the last 6 mo, excluding those with >5 UTIs in the last 6 mo. Participants consumed either 1 capsule of 500 mg/d of whole cranberry powder (Pacran) or placebo. Culture-confirmed UTIs (>108cfu/L) were assessed throughout the intervention period at unscheduled clinic visits whenever participants experienced UTI symptoms and at baseline, 3- and 6-mo clinic visits. Symptomatic suspected UTIs were defined as participant-reported UTI-associated symptoms at unscheduled visits. 

Results Whole cranberry powder capsules reduced culture-confirmed UTI risk compared with placebo by 52% (adjusted relative risk [RR]: 0.48; 95% confidence interval [CI]: 0.26, 0.87; P = 0.01); reduced Escherichia coli UTIs (RR: 0.49; 95% CI: 0.24, 1.01; P = 0.05); reduced incidence of UTI with urinary frequency and urgency symptomatology (RR: 0.29; 95% CI:0.13, 0.63; P < 0.01); delayed time to first UTI episode (adjusted hazard ratio [HR]: 0.36; 95% CI: 0.18, 0.74; P = 0.01); and reduced the mean total number of UTIs per participant (adjusted incidence rate ratio IRR: 0.41; 95% CI: 0.21, 0.79; P = 0.01). Significant differences between groups in incidence of symptomatic suspected UTIs and culture-confirmed dysuria were not observed. Exploratory scores for UTI-related female sexual matters, assessed in a subset of sexually active, consenting females, did not differ significantly between groups. No safety concerns were reported. 

Conclusion This study shows that whole cranberry powder capsules do not impact safety markers and reduce the incidence of culture-confirmed UTI and several other UTI-related outcomes in healthy females with rUTI history.