D-mannose: a promising support for acute urinary tract infections in women. A pilot study

L. Domenici, M. Monti, C. Bracchi, M. Giorgini, V. Colagiovanni, L. Muzii, P. Benedetti Panici

Department of Gynecological Obstetrics and Urologic Sciences, University Sapienza of Rome, Rome, Italy. lavinia.domenici@gmail.com

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• Pharmacology

OBJECTIVE: Urinary tract infections still represent a significant bother for women and result in high costs to the health system. D-mannose is a simple sugar; it seems able to hinder bacteria adhesion to the urothelium. The present study aimed to determine whether D-mannose alone is effective in treating acute urinary tract infections in women and its possible utility in the management of recurrences.

PATIENTS AND METHODS: This is a pilot study, performed between April 2014 and July 2015 at Department of Gynaecological Obstetrics and Urologic Sciences of “Sapienza” University of Rome. A D-mannose compound was administered twice daily for 3 days and then once a day for 10 days. Changes in patients’ symptoms, the therapeutic effects and changes in quality of life (QoL) were evaluated clinically and using a specifically validated questionnaire (UTISA). After described treatment, patients were randomized in receiving or not prophylaxis in the next 6 months.

RESULTS: Mean UTISA scores recorded after completing the treatment, compared with baseline scores, showed a significant improvement of the majority of symptoms (p < 0.05). D-mannose seemed to have had a significant positive effect on UTIs’ resolution and QoL improvement (p = 0.0001). As prophylactic agent administered for 6 months, it showed promising results (4.5% vs. 33.3% recurrences in treated and untreated patients respectively).

CONCLUSIONS: The results of this study suggest that D-mannose can be an effective aid in acute cystitis management and also a successful prophylactic agent in a selected population; however, more studies will certainly be needed to confirm the results of our pilot study.

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