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d-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial

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Abstract

Purpose

To test whether d-mannose powder is effective for recurrent urinary tract infection (UTI) prevention.

Materials and methods

After initial antibiotic treatment of acute cystitis, 308 women with history of recurrent UTI and no other significant comorbidities were randomly allocated to three groups. The first group (n = 103) received prophylaxis with 2 g of d-mannose powder in 200 ml of water daily for 6 months, the second (n = 103) received 50 mg Nitrofurantoin daily, and the third (n = 102) did not receive prophylaxis.

Results

Overall 98 patients (31.8 %) had recurrent UTI: 15 (14.6) in the d-mannose group, 21 (20.4) in Nitrofurantoin group, and 62 (60.8) in no prophylaxis group, with the rate significantly higher in no prophylaxis group compared to active groups (P < 0.001). Patients in d-mannose group and Nitrofurantoin group had a significantly lower risk of recurrent UTI episode during prophylactic therapy compared to patients in no prophylaxis group (RR 0.239 and 0.335, P < 0.0001). In active groups, 17.9 % of patients reported side effects but they were mild and did not require stopping the prophylaxis. Patients in d-mannose group had a significantly lower risk of side effects compared to patients in Nitrofurantoin group (RR 0.276, P < 0.0001), but the clinical importance of this finding is low because Nitrofurantoin was well tolerated.

Conclusions

In our study, d-mannose powder had significantly reduced the risk of recurrent UTI which was no different than in Nitrofurantoin group. More studies will be needed to validate the results of this study, but initial findings show that d-mannose may be useful for UTI prevention.

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References

  1. Foxman B, Brown P (2003) Epidemiology of urinary tract infections: transmission and risk factors, incidence, and costs. Infect Dis Clin North Am 17:227–241

    Article  PubMed  Google Scholar 

  2. Ikäheimo R, Siitonen A, Heiskanen T, Kärkkäinen U, Kuosmanen P, Lipponen P, Mäkelä PH (1996) Recurrence of urinary tract infection in a primary care setting: analysis of a 1-year follow-up of 179 women. Clin Infect Dis 22:91–99

    Article  PubMed  Google Scholar 

  3. Griebling TL (2005) Urologic diseases in America project: trends in resource use for urinary tract infections in women. J Urol 173:1281–1287

    Article  PubMed  Google Scholar 

  4. Nickel JC (2005) Practical management of recurrent urinary tract infections in premenopausal women. Rev Urol 7:11–17

    PubMed Central  PubMed  Google Scholar 

  5. Albert X, Huertas I, Pereiró II, Sanfélix J, Gosalbes V, Perrota C (2004) Antibiotics for preventing recurrent urinary tract infection in non-pregnant women. Cochrane Database Syst Rev 3:CD001209

    PubMed  Google Scholar 

  6. Gupta K, Stamm WE (1999) Pathogenesis and management of recurrent urinary tract infecitons in women. World J Urol 17:415–420

    Article  CAS  PubMed  Google Scholar 

  7. Schito GC, Naber KG, Botto H, Palou J, Mazzei T, Gualco L, Marchese A (2009) The ARESC study: an international survey on the antimicrobial resistance of pathogens involved in uncomplicated urinary tract infections. Int J Antimicrob Agents 34:407–413

    Article  CAS  PubMed  Google Scholar 

  8. Zhanel GG, Hisanaga TL, Laing NM, DeCorby MR, Nichol KA, Palatnik LP, Johnson J, Noreddin A, Harding GK, Nicolle LE, Hoban DJ (2005) Antibiotic resistance in outpatient urinary isolates: final results from the North American urinary tract infection Collaborative Alliance (NAUTICA). Int J Antimicrob Agents 26:380–388

    Article  CAS  PubMed  Google Scholar 

  9. Schaeffer AJ, Amundsen SK, Jones JM (1980) Effect of carbohydrates on adherence of Escherichia coli to human urinary tract epithelial cells. Infect Immun 30:531–537

    CAS  PubMed Central  PubMed  Google Scholar 

  10. Schaeffer AJ, Chmiel JS, Duncan JL, Falkowski WS (1984) Mannose-sensitive adherence of Escherichia coli to epithelial cells from women with recurrent urinary tract infections. J Urol 131:906–910

    CAS  PubMed  Google Scholar 

  11. Bouckaert J, Berglund J, Schembri M, De Genst E, Cools L, Wuhrer M, Hung CS, Pinkner J, Slättegård R, Zavialov A, Choudhury D, Langermann S, Hultgren SJ, Wyns L, Klemm P, Oscarson S, Knight SD, De Greve H (2005) Receptor binding studies disclose a novel class of high-affinity inhibitors of the Escherichia coli FimH adhesin. Mol Microbiol 55:441–455

    Article  CAS  PubMed  Google Scholar 

  12. Michaels EK, Chmiel JS, Plotkin BJ, Schaeffer AJ (1983) Effect of d-mannose and d-glucose on Escherichia coli bacteriuria in rats. Urol Res 11:97–102

    Article  CAS  PubMed  Google Scholar 

  13. Gouin SG, Wellens A, Bouckaert J, Kovensky J (2009) Synthetic multimeric heptyl mannosides as potent antiadhesives of uropathogenic Escherichia coli. Chem Med Chem 4:749–755

    Article  CAS  PubMed  Google Scholar 

  14. Barbosa-Cesnik C, Brown MB, Buxton M, Zhang L, DeBusscher J, Foxman B (2011) Cranberry juice fails to prevent recurrent urinary tract infection: results from a randomized placebo-controlled trial. Clin Infect Dis 52:23–30

    Article  PubMed  Google Scholar 

  15. Kontiokari T, Sundqvist K, Nuutinen M, Pokka T, Koskela M, Uhari M (2001) Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women. BMJ 322:1571

    Article  CAS  PubMed  Google Scholar 

  16. Semins MJ, Shore AD, Makary MA, Weiner J, Matlaga BR (2012) The impact of obesity on urinary tract infection risk. Urology 79:266–269

    Article  PubMed  Google Scholar 

  17. Saliba W, Barnett-Griness O, Rennert G (2012) The association between obesity and urinary tract infection. Eur J Intern Med 24:127–131

    Article  PubMed  Google Scholar 

  18. Milo G, Katchman EA, Paul M, Christiaens T, Baerheim A, Leibovici L (2005) Duration of antibacterial treatment for uncomplicated urinary tract infection in women. Cochrane Database Syst Rev 18:CD004682

    Google Scholar 

  19. Schmiemann G, Gágyor I, Hummers-Pradier E, Bleidorn J (2012) Resistance profiles of urinary tract infections in general practice—an observational study. BMC Urol 12:33

    Article  PubMed Central  PubMed  Google Scholar 

  20. Brumfitt W, Hamilton-Miller JM (1998) Efficacy and safety profile of long-term nitrofurantoin in urinary infections: 18 years’ experience. J Antimicrob Chemother 42:363–371

    Article  CAS  PubMed  Google Scholar 

  21. Guay DR (2009) Cranberry and urinary tract infections. Drugs 69:775–807

    Article  CAS  PubMed  Google Scholar 

  22. Gupta K, Chou MY, Howell A, Wobbe C, Grady R, Stapleton AE (2007) Cranberry products inhibit adherence of p-fimbriated Escherichia coli to primary cultured bladder and vaginal epithelial cells. J Urol 177:2357–2360

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. Jepson RG, Williams G, Craig JC (2012) Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev 10:CD001321

    PubMed  Google Scholar 

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All authors state that they have no conflict of interest.

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Correspondence to Silvio Altarac.

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Kranjčec, B., Papeš, D. & Altarac, S. d-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial. World J Urol 32, 79–84 (2014). https://doi.org/10.1007/s00345-013-1091-6

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  • DOI: https://doi.org/10.1007/s00345-013-1091-6

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