Next Article in Journal
Potential Environmental and Human Health Risks Caused by Antibiotic-Resistant Bacteria (ARB), Antibiotic Resistance Genes (ARGs) and Emerging Contaminants (ECs) from Municipal Solid Waste (MSW) Landfill
Next Article in Special Issue
Treatment of Urinary Tract Infections with Canephron® in Germany: A Retrospective Database Analysis
Previous Article in Journal
Antimicrobial-Resistance of Food-Borne Pathogens
 
 
Review

Role of D-Mannose in the Prevention of Recurrent Uncomplicated Cystitis: State of the Art and Future Perspectives

1
Department of Urology, Sant’Andrea Hospital, Sapienza University of Rome, 00141 Rome, Italy
2
Department of Translational Research and New Technologies, Urology Unit, University of Pisa, 56010 Pisa, Italy
3
Department of Surgical, Oncological and Oral Sciences, Urology Section, University of Palermo, 90121 Palermo, Italy
4
Department of Human and Pediatric Pathology “Gaetano Barresi”, Urology Section, University of Messina, 98168 Messina, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Luísa Peixe
Antibiotics 2021, 10(4), 373; https://doi.org/10.3390/antibiotics10040373
Received: 8 March 2021 / Revised: 25 March 2021 / Accepted: 30 March 2021 / Published: 1 April 2021
(This article belongs to the Special Issue Difficult to Treat Infections in Urology)
Background: Urinary tract infections (UTI) are highly frequent in women, with a significant impact on healthcare resources. Although antibiotics still represent the standard treatment to manage recurrent UTI (rUTI), D-mannose, an inert monosaccharide that is metabolized and excreted in urine and acts by inhibiting bacterial adhesion to the urothelium, represents a promising nonantibiotic prevention strategy. The aim of this narrative review is to critically analyze clinical studies reporting data concerning the efficacy and safety of D-mannose in the management of rUTIs. Methods: A non-systematic literature search, using the Pubmed, EMBASE, Scopus, Web of science, Cochrane Central Register of Controlled Trials, and Cochrane Central Database of Systematic Reviews databases, was performed for relevant articles published between January 2010 and January 2021. The following Medical Subjects Heading were used: “female/woman”, “urinary tract infection”, and “D-mannose”. Only clinical studies, systematic reviews, and meta-analyses reporting efficacy or safety data on D-mannose versus placebo or other competitors were selected for the present review. Evidence was limited to human data. The selected studies were organized in two categories according to the presence or not of a competitor to D-mannose. Results: After exclusion of non-pertinent studies/articles, 13 studies were analyzed. In detail, six were randomized controlled trials (RCTs), one a randomized cross-over trial, five prospective cohort studies, and one a retrospective analysis. Seven studies compared D-mannose to placebo or others drugs/dietary supplements. Six studies evaluated the efficacy of D-mannose comparing follow-up data with the baseline. D-mannose is well tolerated, with few reported adverse events (diarrhea was reported in about 8% of patients receiving 2 g of D-mannose for at least 6 months). Most of the studies also showed D-mannose can play a role in the prevention or rUTI or urodynamics-associated UTI and can overlap antibiotic treatments in some cases. The possibility to combine D-mannose with polyphenols or Lactobacillus seems another important option for UTI prophylaxis. However, the quality of the collected studies was very low, generating, consequently, a weak grade of recommendations as suggested by international guidelines. Data on D-mannose dose, frequency, and duration of treatment are still lacking. Conclusion: D-mannose alone or in combination with several dietary supplements or Lactobacillus has a potential role in the non antimicrobial prophylaxis or recurrent UTI in women. Despite its frequent prescription in real-life practice, we believe that further well-designed studies are urgently needed to definitively support the role of D-mannose in the management of recurrent UTIs in women. View Full-Text
Keywords: female; urinary tract infections; UTI; D-mannose; cystitis; prevention; treatment female; urinary tract infections; UTI; D-mannose; cystitis; prevention; treatment
MDPI and ACS Style

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

AMA Style

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 Style

De 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

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop