Benefits
Urinary tract health in women
In a 6-month placebo-controlled trial in 150 women with a history of recurrent urinary tract infections, one 500 mg capsule a day lowered the risk of a urine-culture-confirmed infection by 52% (relative risk 0.48) and delayed the first one. Symptom-based suspected infections did not differ significantly (p=0.08). The trial was industry sponsored, and the FDA calls the evidence for cranberry supplements limited.
Second trial of the same powder
An earlier 6-month randomized trial in 182 women with 2 or more infections in the past year tested 500 mg a day of Pacran (its PAC content was reported as 0.56% by a different test method). Fewer women on Pacran had an infection (10.8% versus 25.8%). The European Food Safety Authority noted protocol deviations and judged that this trial did not show a consistent effect.
Safety over 6 months
In the 150-woman trial, no safety concerns were reported over 6 months of daily use and blood safety markers were unaffected. In the 2023 Cochrane review of cranberry products, gastrointestinal side effects probably did not differ from placebo. Longer-term data on this ingredient are lacking, and cranberry should not replace a treatment your clinician prescribes.
Mechanism of action
Anti-adhesion of E. coli
Cranberry proanthocyanidins (PACs) block the attachment of P-fimbriated E. coli to the cells lining the bladder in laboratory and urine-sample experiments. Less attachment is thought to let more bacteria be flushed out with urine. This has not been proven as the mechanism in people, and cranberry does not kill bacteria.
Clinical trials
Randomized, double-blind, placebo-controlled, single-centre trial of 500 mg/day whole cranberry fruit powder for 6 months; the brand is not named in the abstract, but EFSA identifies it as Pacran with 0.56% PACs by the BL-DMAC method (Vostalova et al. 2015, Phytother Res)
182 women with 2 or more UTIs in the previous year (89 cranberry, 93 placebo).
In the intent-to-treat analysis, 10.8% of the cranberry group versus 25.8% of the placebo group had a UTI (p=0.04), and time to a first UTI was longer (p=0.04). Blood tests stayed normal. EFSA found inconsistencies between the study report and the publication and protocol deviations, and concluded the trial did not show a consistent effect of Pacran on UTI incidence.
Multicenter, randomized, double-blind, placebo-controlled trial of one 500 mg Pacran capsule a day for 6 months (Stonehouse et al. 2025, Am J Clin Nutr)
150 healthy women aged 18 to 65 with 3 or more UTIs in the past year or up to 2 in the past 6 months.
The primary outcome, culture-confirmed UTI, was 52% less likely on Pacran (adjusted relative risk 0.48, 95% CI 0.26 to 0.87, p=0.01). Time to a first UTI was longer (hazard ratio 0.36) and total UTIs were lower (rate ratio 0.41). E. coli UTIs were borderline (relative risk 0.49, 95% CI 0.24 to 1.01, p=0.05). Symptom-based suspected UTIs (p=0.08) and culture-confirmed painful urination (p=0.10) did not differ significantly. No safety concerns were reported. Sponsored by Swisse Wellness; Givaudan supplied the powder.