Oral D-Mannose in the Prevention and Treatment of Recurrent Urinary Tract Infections: A Review

Porru D, Regina C, Fiorello N, Gardella B, Spinillo A and Jallous H

Department of Urology, Fondazione IRCCS Policlinico S. Matteo, Italy
Department of Gynecology and Obstetrics, Fondazione IRCCS Policlinico S. Matteo, Italy

^*Correspondance to: Daniele Porru 

 PDF  Full Text DOI: 10.25107/2474-1647.2624

Abstract

Background: The results of several studies reveal that antibiotics may promote treatment resistance by causing alterations in the intestinal flora. The development of a gut reservoir of resistant bacteria promotes the development of UTIs through autoinfection. The aim of this review is to address clinical reliability, efficacy and safety of long-term treatment with oral D-Mannose for the prevention of Recurrent Urinary Tract Infections (RUTIs) in females. Materials and Methods: Evidence Acquisition A comprehensive Medline, Embase, Scopus and Cochrane search was performed for English language reports published before December 2018 using the term "recurrent urinary tract infections and d mannose." We searched Medline, Embase, Scopus and the Cochrane Register of Controlled Trials since January 2010 to December 2018. Eligible studies did not include non-oral therapy, local (vaginal) treatment in women with RUTIs. We identified eligible original articles. The heterogeneity of the available studies, their different rationale and aim, the assumption of D-mannose for prophylaxis or treatment of recurrent UTIs need to be taken into account. Results: Evidence Synthesis Oral d mannose performs well in the prevention of UTIs recurrences, significant improvement of urinary symptoms was observed, the disease free time was longer in the groups of patients under prophylaxis with d mannose in comparison with control groups (no treatment, antibiotic prophylaxis, prophylaxis with Proanthocyanidin (PAC) etc. Conclusion: D-mannose prolonged the recurrence-free interval of recurrent UTIs, thus reducing the prolonged or cyclical use of antibiotics, generating an improvement of clinical symptoms, with a significant difference between treatment and control groups (no treatment, antibiotic prophylaxis, prophylaxis with Proanthocyanidin). However, the majority of clinical trials used an association of different substances commingled with d mannose, dosages and regimens of d mannose were different. For this reason the evidence of efficacy of D-mannose remains low.

Keywords

Recurrent urinary tract infections; Urinary tract infections; D-mannose; Antibiotic prophylaxis; Proanthocyanidin

Cite the article

Porru D, Regina C, Fiorello N, Gardella B, Spinillo A, Jallous H. Oral D-Mannose in the Prevention and Treatment of Recurrent Urinary Tract Infections: A Review. Clin Surg. 2019; 4: 2624.