Unsweetened Cranberry Juice for Urethritis

Unsweetened cranberry juice is not effective for treating urethritis and should not be recommended as a treatment option. 1, 2

Understanding Urethritis

Urethritis is inflammation of the urethra primarily caused by infectious agents:

Most commonly caused by sexually transmitted infections including Neisseria gonorrhoeae (gonococcal urethritis) or Chlamydia trachomatis, Mycoplasma genitalium, and Trichomonas vaginalis (non-gonococcal urethritis) 1
Presents with symptoms including dysuria, urethral discharge, urethral discomfort, and erythema 1
Diagnosis requires typical symptoms plus either mucopurulent discharge, positive Gram stain, or first-void urinalysis showing elevated white blood cells 1, 2

Appropriate antibiotic therapy is the only effective treatment for urethritis 1, 3
First-line empiric treatment consists of:
- Ceftriaxone plus doxycycline for empiric coverage 1
- Treatment should be targeted to the specific organism once identified 1, 3
Patients should abstain from sexual activity for 7 days after starting treatment 1, 3

While cranberry products have been studied for UTI prevention, there is no evidence supporting their use in treating urethritis 4
Cranberry products work through proanthocyanidins (PACs) that may prevent bacterial adhesion to the urothelium, but this mechanism is not effective for treating established infections 4
Even for UTI prevention (not treatment), evidence for cranberry efficacy is inconsistent and of low quality 4, 5

Urethritis requires targeted antimicrobial therapy to eradicate the causative pathogens 1, 2, 3
Cranberry products have only been studied for UTI prevention, not for urethritis treatment 4
Even for UTI prevention, a Cochrane review found that cranberry products did not significantly reduce symptomatic UTI recurrence in patients with neuropathic bladder or spinal cord injury 4
The American Urological Association only gives a conditional recommendation (Grade C evidence) for cranberry as prophylaxis for recurrent UTIs, not as treatment for active infections 4

Delaying appropriate antibiotic therapy while trying alternative remedies can lead to complications including prostatitis and epididymitis 6, 7
Empirical treatments without proper diagnostic testing are no longer recommended due to increasing antibiotic resistance 3
Nucleic acid amplification testing (NAAT) is essential for accurate pathogen identification and targeted therapy 3
Untreated or inadequately treated urethritis can increase the risk of HIV transmission 2

When patients present with urethritis symptoms, clinicians should:

Perform appropriate diagnostic testing to identify the causative organism 1, 3
Prescribe targeted antibiotic therapy based on the identified pathogen 1, 3
Advise against relying on cranberry juice or other non-antibiotic remedies for treatment 4
Ensure partner notification and treatment to prevent reinfection 1, 3