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World J Urol (2014) 32:7984 DOI 10.1007/s00345-013-1091-6
ORIGINAL ARTICLE
D-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial
Bojana Kranjec Dino Pape Silvio Altarac
Received: 24 February 2013 / Accepted: 20 April 2013 / Published online: 30 April 2013 Springer-Verlag Berlin Heidelberg 2013
AbstractPurpose 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 signicant comorbidities were randomly allocated to three groups. The rst 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 signicantly higher in no prophylaxis group compared to active groups (P \ 0.001). Patients in D-mannose group and Nitrofurantoin group had a signicantly 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 signicantly lower risk of side effects
compared to patients in Nitrofurantoin group (RR 0.276, P \ 0.0001), but the clinical importance of this nding is low because Nitrofurantoin was well tolerated.
Conclusions In our study, D-mannose powder had signicantly 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 ndings show that D-mannose may be useful for UTI prevention.
Keywords Urinary tract infection Recurrent Cystitis
D-mannose Prophylaxis
Introduction
Urinary tract infections (UTI) are common, and it is estimated that around 11 % of women aged over 18 have an UTI each year [1]. Simple isolated cases of UTIs do not cause severe problems for patients. On the other hand, recurrent UTIs (dened as 2 infections in 6 months or...