Cranberry Products And Urinary Tract Infections (UTIs)

The Question

Can the ingestion of cranberry products help to prevent or treat urinary tract infections (UTIs)?

The Recommendation

Preventing urinary tract infections

We suggest using cranberry products (e.g. capsules, tablets, powder, juice or extract) to reduce the risk of symptomatic urinary tract infections (UTIs) in:

women with recurrent UTIs (conditional recommendation, moderate quality evidence ⊕⊕⊕⊝)
children (conditional recommendation, moderate quality evidence ⊕⊕⊕⊝)
adults who are susceptible to a UTI due to medical or surgical intervention (conditional recommendation, low quality evidence ⊕⊕⊝⊝).

We suggest not using cranberry products to reduce the risk of symptomatic UTIs in:

older adults living in an institution (conditional recommendation, moderate quality evidence ⊕⊕⊕⊝)
pregnant women (conditional recommendation, moderate quality evidence ⊕⊕⊕⊝)
adults with bladder dysfunction (conditional recommendation, low quality evidence ⊕⊕⊝⊝).

Cranberry products may increase the risk of gastrointestinal side-effects (conditional recommendation, moderate quality evidence ⊕⊕⊕⊝).

Treating urinary tract infections

No recommendations can be made regarding cranberry products for the treatment of UTIs in adults or children due to a lack of studies. Grade D

The Remarks

The recommendation for women with recurrent UTIs, children and adults at risk of a UTI due to medical or surgical intervention (e.g. pelvic radiation, gynecological surgery) places a high value on the reduction of symptomatic UTIs through the use of cranberry products and considers that cranberry products may cause gastrointestinal side-effects. This recommendation applies to any kind of cranberry product. The active component of cranberries is proanthocyanidin, but the optimal dose is not known and cranberry products can vary significantly in the amount of proanthocyanidin they contain, with some containing none or very little (Williams et al., 2023).

The recommendation against the use of cranberry products to prevent UTIs in older adults living in an institution (e.g. long-term care home), pregnant women and adults with bladder dysfunction places a high value on evidence from RCTs that showed no benefit in these populations. Research on other client-important outcomes (e.g. health-related quality of life) and costs was not included. Personal preferences should be discussed with clients individually.

A subgroup analysis based on the social determinants of health was not conducted. Due to the costs associated with purchasing cranberry products and the need to store products, the intervention may be inaccessible to individuals with financial constraints and those experiencing homelessness. Determining the optimal dose of proanthocyanidin should be a priority for researchers (Williams et al., 2023).

To see the full practice question, including the Summary of Evidence, Evidence to Decision Summary and References, click here.

Looking for more content on urinary tract infections (UTIs)? Check out the Urology - Urinary Tract Infection Knowledge Pathway.

Cranberry Urinary Tract Infection

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Cranberry Products And Urinary Tract Infections (UTIs)