Don’t recommend cranberries to TREAT UTIs ❌. There’s no evidence supporting their efficacy. Use antibiotics for treatment instead.
- Cranberries for PREVENTION? Conflicting data 🤔. Cranberries may help prevent E. coli from sticking to the bladder, but they don’t guarantee prevention of recurrent UTIs (rUTIs).
- Recommendation: Don’t routinely recommend cranberries for rUTIs. But if patients want to try, it's generally safe (potential for mild GI upset).
- Suggested doses for those who want to try cranberries: for juice🧃 300 mL/day, for capsules 💊 500 mg/day or 💊 400 mg/day
- Encourage alternatives: For patients prone to rUTIs, discuss alternatives like antibiotic prophylaxis (TMP/SMX or nitrofurantoin) 💊💉.
- Contraceptives: Diaphragms and spermicides increase UTI risk 🚫. Suggest other contraceptive methods when appropriate.
- Guideline recommendations
- AUA/CUA/SUFU 2019: Suggest offering cranberry prophylaxis to patients with recurrent UTIs (rUTIs).
- EAU 2024: Recommend cranberry products for reducing rUTIs, though evidence quality is low.
- AAFP 2024: Suggest cranberry products for preventing rUTIs in females.
- SEIMC 2017: Recommend cranberry products containing ≥72 mg PACs for 6-12 months, though they are less effective than antibiotic prophylaxis.
- SOGC 2017: Inform patients of the efficacy of cranberry products in reducing rUTIs.
- IDSA 2010: Do not recommend cranberry products for preventing catheter-associated UTIs (CA-UTI) or catheter-associated asymptomatic bacteriuria (CA-ASB).
References
- Barbosa-Cesnik C, Brown MB, Buxton M, Zhang L, DeBusscher J, Foxman B. Cranberry juice fails to prevent recurrent urinary tract infection: results from a randomized placebo-controlled trial. Clin Infect Dis. 2011;52(1):23-30.
- Guay DR. Cranberry and urinary tract infections. Drugs. 2009;69(7):775-807.
- Williams G, Hahn D, Stephens JH, Craig JC, Hodson EM. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. 2023;4(4):CD001321.
- Jepson RG, Mihaljevic L, Craig J. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. 2001;(3):CD001321.
