Role of D-Mannose in the Prevention of Recurrent Uncomplicated Cystitis: State of the Art and Future Perspectives
Abstract
:1. Introduction
2. Evidence Acquisition
3. Evidence Synthesis
3.1. D-Mannose: UTI Prevention and Treatment
3.2. D-Mannose Versus Antibiotics or Polyphenols: UTI Prevention and Treatment
4. D-Mannose: Adverse Events
5. Discussion
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Conflicts of Interest
References
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Author, Year | Study Design | Study Population | Inclusion Criteria | Treatment | Main Results |
---|---|---|---|---|---|
Efros et al., 2010 | Prospective | 23 Women 18–75 years | Recurrent UTIs | -Proantinox ° | 9% UTI Improvement in QoL |
Vicariotto, 2014 | Prospective | 35 Women Premenopausal | Acute symptomatic UTI | D-mannose 250 mg Tara Gum 250 mg Proanthocyanidin cranberry extract + Probiotics * | Reduction in Nitrites and Leucocytes |
Domenici, 2016 | Prospective | 43 Women | Acute symptomatic UTI | D-mannose (1.5 g), sodium bicarbonate, sorbitol, and silicon dioxide. | Reduced number of UTIs. |
Phe, 2017 | Prospective | 22 Men and women with multiple sclerosis | Recurrent UTIs | D-mannose powder (1.5 g) | Decrease in the number of UTIs. |
Marchiori, 2017 | Retrospective | 60 breast cancer women | Breast cancer survivors | Antibiotics + Mannose vs. Antibiotics | Greater efficacy of combination treatment in preventing UTIs |
Genovese, 2018 | Randomized | 72 Women | Recurrent UTIs | A: D-mannose Berberine, Arbutin and Birch B: D-mannose, Berberine, Arbutin, Birch, Forskolin C: D-mannose, Proanthocyanidis | A and B > C in terms of number of UTI |
Del Popolo, 2018 | Prospective | 78 Patients Neurogenic bladder | Recurrent UTIs | D-mannose (1 g) + dry willow extract (200 mg) | D-mannose improved VAS scores and frequency of incontinence episodes. |
Author, Year | Study Design | Study Population | Inclusion Criteria | Treatment | Main Results |
---|---|---|---|---|---|
Kranjcec et al., 2014 | Randomized | 308 Women 18–75 years | Recurrent UTIs |
| D-mannose (15%) and Nitrofurantoin (20%) groups presented a lower risk of UTIs when compared to controls (61%). |
Porru, 2014 | Randomized | 60 Women | Recurrent UTIs |
| Mean time to UTI 52 vs. 200 days favors D-mannose |
Palleschi, 2017 | Randomized | 42 Men and 38 Women | Post Urodynamic |
| No difference in terms of UTis post- urodynamics. |
De Leo 2017 | Randomized | 150 Women | Recurrent UTIs |
| Reduction of dysuria and frequency. |
Salinas-Casado 2018 | Randomized | 150 Women | Recurrent UTIs |
| 95 days vs. 79 days disease-free favor the D-mannose group. |
Salinas-Casado 2020 | Randomized | 184 Women | Recurrent UTIs |
| 27% vs. 50% of UTIs favors the D-mannose group. |
Characteristics | Hormonal Replacement | Immunoactive Prophylaxis | Lactobacillus | Cranberry | Hyaluronic Acid | D-mannose |
---|---|---|---|---|---|---|
Data maturity | Solid | Solid | Poor | Poor | Poor | Poor |
Route of Administration | Vaginal | Oral | Oral | Oral | Endovesical Oral | Oral |
Adverse Events | Vaginal discomfort, irritation, burning, itching | None | None | None | Burning during instillation (78%) | Diarrhea (<8%) |
EAU Guidelines on Urinary Tract Infections | Recommended for post-menopausal women (weak) | More effective than placebo (strong) | Further trials are needed before recommendation for or against its use | Contradictory results. No recommendation | No recommendation | Data indicative but not sufficient for recommendation |
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De Nunzio, C.; Bartoletti, R.; Tubaro, A.; Simonato, A.; Ficarra, V. Role of D-Mannose in the Prevention of Recurrent Uncomplicated Cystitis: State of the Art and Future Perspectives. Antibiotics 2021, 10, 373. https://doi.org/10.3390/antibiotics10040373
De Nunzio C, Bartoletti R, Tubaro A, Simonato A, Ficarra V. Role of D-Mannose in the Prevention of Recurrent Uncomplicated Cystitis: State of the Art and Future Perspectives. Antibiotics. 2021; 10(4):373. https://doi.org/10.3390/antibiotics10040373
Chicago/Turabian StyleDe Nunzio, Cosimo, Riccardo Bartoletti, Andrea Tubaro, Alchiede Simonato, and Vincenzo Ficarra. 2021. "Role of D-Mannose in the Prevention of Recurrent Uncomplicated Cystitis: State of the Art and Future Perspectives" Antibiotics 10, no. 4: 373. https://doi.org/10.3390/antibiotics10040373