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Cranberries and Urinary Tract Infections: What Cochrane Found

What the Cochrane reviews found on cranberry juice and products for preventing and treating urinary tract infections, who benefited, who did not, and safety points.

Content last updated . This page has not been medically reviewed.

Safety first. Natural products can cause side effects and interact with medicines. Read functional food safety before you use anything on this page.

Read this first

Cranberry is not a treatment for a urinary tract infection (UTI). NCCIH says cranberry is not recommended as a treatment for existing UTIs in any population, and that anyone who thinks they have a UTI should see a health care provider for diagnosis and treatment. [1] The NHS lists reasons to seek prompt medical advice, including a very high or low temperature or shivering, blood in the urine, pregnancy, and a child aged 15 or younger. It warns that some of these could be signs of a kidney infection, which can be serious and could cause sepsis. [2] The NHS says confusion, drowsiness or difficulty speaking with a suspected UTI need emergency help; in the U.S. that means calling 911. [2]

What this page covers

American cranberry (Vaccinium macrocarpon) fruit is the plant studied. [1] Cranberry has a history of traditional use in dyes, food and medicine among Native Americans and later European settlers; that history is not evidence that it works. [1] Today it is mainly promoted for preventing recurrent UTIs. [1] This page is about juice and fruit products as foods. Capsules and extracts are covered at Cranberry in Herbs & Botanicals.

Prevention versus treatment

The two questions have different answers, and Cochrane reviewed each.
QuestionWhat the source foundStrength of evidenceWho and what was studied
Preventing UTIs, all groupsCranberry products reduced the risk of symptomatic, culture-verified UTIs overall. [3]Moderate certainty (Cochrane)50 trials, 8857 people; juice, tablets and other products [3]
Women with recurrent UTIsProbably reduced risk (RR 0.74, 95% CI 0.55 to 0.99). [3]Promising, with a wide range of results8 trials [3]
ChildrenProbably reduced risk (RR 0.46, 95% CI 0.32 to 0.68). [3]Promising5 trials [3]
Older people in care, pregnant women, bladder emptying problemsThe review says the evidence does not support use in these groups. [3]Little or no benefit shownElderly institutionalised people, pregnant women, adults with neuromuscular bladder problems [3]
Compared with antibioticsMay make little or no difference in symptomatic, culture-verified UTIs. [3]Uncertain2 trials [3]
Juice versus tabletsUnclear whether they differ. [3]Very low certaintyFew trials [3]
Treating an existing UTINo randomized trial of cranberry juice for treatment was found. [4]No good evidence of benefitCochrane review 2023 [4]

The NHS says cranberry products may help prevent UTIs for people who keep getting them, but there is no evidence they ease symptoms or treat a UTI that has already started. [2] NCCIH adds that results are inconsistent. [1]

Why the product matters

Cranberries contain proanthocyanidins (PACs), which Cochrane describes as inhibiting the sticking of certain E. coli bacteria to the cells lining the bladder. [3] NCCIH notes that processing into tablets or capsules can lower PAC concentration. [1] In the U.S., FDA allows a label claim of "limited" evidence for cranberry supplements and "limited and inconsistent" evidence for cranberry juice beverages (2020, as reported by NCCIH). [1] The reviews did not find that juice beats tablets, or the reverse. [3]

Frequently asked questions

Does cranberry juice cure a UTI?

No. Cochrane found no randomized trial of cranberry juice for treating a UTI. [4] NCCIH says not to use cranberry in place of a proven treatment. [1]

Can cranberry prevent UTIs?

In a Cochrane review, cranberry products probably reduced UTIs in women with recurrent UTIs and in children, but not in older people in care homes or pregnant women. [3]

Is cranberry as good as antibiotics?

Two trials suggested cranberry may make little or no difference to symptomatic, culture-verified UTIs, so the evidence is uncertain. [3] A prescriber decides about antibiotics.

Is it safe to take cranberry with warfarin?

Sources disagree: the NHS says avoid cranberry products on warfarin, while NCCIH calls the evidence conflicting. [2][1] Ask the prescriber or pharmacist.

What if symptoms keep coming back or get worse?

See a clinician for testing. The NHS lists repeat infections, symptoms that worsen quickly, fever or shivering, and pregnancy among reasons for prompt advice. [2]

More details: evidence, limits and cautions

The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.

Safety
  • Sugar. The NHS warns that cranberry products can contain a lot of sugar. [2] Read the label; see Reading food labels.
  • Warfarin. The NHS says people taking warfarin should avoid cranberry products. [2] NCCIH says the evidence on whether cranberry interacts with warfarin is conflicting. [1] Ask the prescriber or pharmacist; do not change a prescribed medicine on your own. See How interactions work.
  • Stomach upset. NCCIH says very large amounts can cause stomach upset and diarrhea, particularly in young children. [1]
  • Pregnancy and breastfeeding. Some studies suggest cranberry is safe in food-level amounts, but NCCIH says the evidence is not conclusive for larger amounts. [1] The NHS says to speak to a doctor first during pregnancy. [2] The Cochrane review does not support use for preventing UTIs in pregnancy. [3]
  • Side effects in trials. Stomach and gut side effects probably did not differ from placebo or no treatment. [3]

For symptoms, causes and care, read Urinary tract infections and urinary symptoms. For other juices and sugar, see Fruit juice vs whole fruit.

References
Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.