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

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.

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.

OBJECTIVE: This study was designed to determine the effect of cranberry extract used in patients with single urinary tract infections. 

METHODS: Patients with simple-type urinary tract infections were divided into two groups. Treatment with fosfomycin or cranberry tablet was started. On days 1, 3, and 7 of the treatment, whether there was a decrease in the complaints was evaluated with a Likert-type scale. The recovery status of urinary tract infections and the well-being of patients were compared via antibiotic and cranberry groups. 

RESULTS: After the treatment, the leukocyte levels of the cranberry users were at the same level as those of the other group, and the rate of well-being and the portion of patients that reported to be very well on days 3 and 7 in the cranberry group was significantly higher compared with the fosfomycin group (p<0.05). 

CONCLUSION: Considering the results of this study, it was determined that the patient's complaints decreased from day 3 and their well-being increased with the use of cranberry only. Specifically, on day 7, the well-being of the cranberry group was higher than that of the fosfomycin group. For this reason, cranberry is a favorable alternative to antibiotics in uncomplicated and simple urinary tract infections.

The mechanism by which cranberry-lingonberry juice (CLJ) prevents urinary tract infections (UTI) in children remains unknown. We hypothesized that it alters the composition of the gut or urinary microbiome. Altogether, 113 children with UTIs were randomly allocated to drink either CLJ or a placebo juice for 6 months. We collected urinary samples at 3 months and fecal samples at 3, 6 and 12 months and used next-generation sequencing of the bacterial 16S gene. The children who consumed CLJ had a lower abundance of Proteobacteria (p = 0.03) and a higher abundance of Firmicutes phylum (p = 0.04) in their urinary microbiome at 3 months than did those in the placebo group. The abundance of Escherichia coli in the urinary microbiome was 6% in the CLJ group and 13% in the placebo group (p = 0.42). In the gut microbiome the abundance of Actinobacteria at 3 and 12 months was higher in the children receiving CLJ. The diversity of the urinary and gut microbiome did not differ between the groups. The children drinking CLJ had a different urinary and gut microbiome from those receiving a placebo juice. A healthy urinary microbiome may be important in preventing UTIs in children.

Objective: Recent guidelines indicated that, in addition to antibiotics, nonantibiotic interventions serve as available preventive options for urinary tract infections (UTIs). This study aimed to compare the efficacy and safety of various nonantibiotic interventions in preventing UTIs. 

Methods: The authors systematically searched databases for eligible studies. The inclusion criteria encompassed randomized controlled trials (RCTs) focusing on one or more nonantibiotic interventions for UTI prevention, with the incidence of UTIs being a key outcome measure. Subgroup analyses were performed according to age, sex, and follow-up. 

Results: 50 RCTs comprising 10,495 subjects and investigating 14 interventions, were included. Nearly 80% of the RCTs utilized double-blind or triple-blind designs. In the whole group, D-mannose (risk ratio [RR] 0.34, 0.21 to 0.56), vaccine (RR 0.65, 0.52 to 0.82), probiotics (RR 0.69, 0.50 to 0.94), cranberry (RR 0.72, 0.60 to 0.87), and triple therapy (cranberry plus probiotics plus vitamin A) (RR 0.27, 0.09 to 0.87), exhibited a significant reduction in UTI incidence compared to the placebo. Probiotics (RR 0.50, 0.28 to 0.89) were the most effective in the nonadult group, while vitamin D (RR 0.46, 0.27 to 0.81) showed the highest efficacy in the long follow-up group (>= 1 year). There was no significant difference in the incidence of adverse events between the interventions and the placebo group. 

Conclusions: D-mannose, triple therapy, vaccine, probiotics, and cranberry serve as potential nonantibiotic intervention options for clinical UTI prevention.

One complication of cutaneous ureterostomy is urinary stone formation, which may lead to recurrent pyelonephritis. Frequent catheter changes and the prophylactic administration of antibiotics are commonly used to prevent stone formation. Cranberry products have been reported to inhibit stone formation in indwelling urethral catheters. We herein examined the inhibitory effects of a cranberry product on stone formation in a case of catheter occlusion due to stone formation after cutaneous ureterostomy. The results obtained indicate the potential of cranberry products to prevent stone formation after cutaneous ureterostomy requiring catheter placement.

Background:  The adherence of p-fimbriated Escherichia coli (E. coli) to urothelial cells leading to recurrent urinary tract infections (rUTIs) may be prevented by proanthocyanidins (PACs) contained in American cranberries.

Purpose: The purpose of this clinical trial was to assess the clinical utility of prophylactic use of high-dose PACs daily in women with a history of rUTIs.

Materials and methods: 172 adult women with a history of rUTIs, defined as >= 2 within a 6-month period or >= 3 within a 12-month period were enrolled and randomized in two groups to receive either Cysticlean (TM) 240 mg or placebo for a 12-month period. Urine samples, vaginal and rectal swabs were collected at initial and quarterly study visits. The primary study endpoints were the number of urinary tract infections (UTIs) and changes in Quality of Life (QoL), assessed by the 36-Item Short Form Survey (SF-36) questionnaire.

Results: 160 adult women of median age 40 years old (range 19-82) were finally analyzed in this randomized, placebo-controlled, double-blinded clinical trial. In response to intervention, the number of UTIs was significantly lower (Incidence rate ratio IRR 0.49, p < 0.001) and QoL was slightly improved. The numbers of E. coli isolates detected in vaginal (IRR 0.71, p value < 0.001) and in rectal swabs (IRR 0.87, p value < 0.001) were also significantly decreased. No adverse events were reported.

Conclusion: The daily use of Cysticlean (TM) 240 mg was associated with a reduction of UTIs and a prolongation of UTI-free survival compared to placebo treatment, supporting its use as prophylaxis in this patient population.