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Table 1 Clinical trials in acute UTI/rUTIs with treatment supplementations including D-mannose only

From: Role of D-mannose in urinary tract infections – a narrative review

Reference

Study Design

Subjects and groups

Supplementation

Main Findings (including safety)

Domenici 2016 [67]

Pilot study, randomized for long-term prophylactic effect

18–65 year old women with acute cystitis and/or history of rUTIs

n = 43

Acute: 13 days; 1.5 g D-mannose twice daily for 3 days and then once a day for 10 days.

Long-term: 6 months; once a day for a week every other month

D-mannose has potential as an effective agent for both acute UTI and as prophylactic for rUTI in a specific population

No AEs

Kranjčec 2014 [68]

Prospective, randomized, open-label, controlled study

18 + years old women with acute cystitis and a history of recurrent cystitis in 3 groups:

1. (n = 103) D-mannose

2. (n = 103) Nitrofurantoin

3. (n = 102) no prophylaxis

n = 308

Long-term: 6 months once a day

D-mannose: 2 g in 200 ml water Nitrofurantoin: 50 mg

D-mannose may be beneficial for UTI prevention. The decreased recurrence rate did not differ between patients who took Nitrofurantoin and D-mannose

Mild AEs in 7.8% (diarrhea) of D-mannose group compared to 27.2% (various AEs) in Nitrofurantoin group

Phe 2017 [69]

A single-center, open-label, feasibility study

46–59 year old MS patients using and not using urinary catheters, experiencing rUTIs

n = 22

Long-term: 16 weeks, 1.5 g D-mannose twice a day

D-mannose is safe and feasible supplementation for patients having MS. For efficacy, further studies are needed.

No AEs

Porru 2014 [70]

Pilot study, randomized, cross-over trial

22–54 years old female patients with acute symptomatic UTI and ≥ 3rUTIs during the preceding 12 months

n = 60

Long-term cross-over design:

Group 1: 1 g D-mannose 3 times a day, every 8 h for 2 weeks, and subsequently 1 g twice a day for 22 weeks.

Group 2: 5-day antibiotic therapy with trimethoprim/sulfamethoxazole 160 mg/800 mg twice a day, followed by a single dose at bedtime for 1 week each month in the following 23 weeks

Cross-over point at week 24

D-mannose was shown to be effective and safe in preventing rUTIs in women. The proportion of infection free women was greater in D-mannose group compared to antibiotic group.

No AEs mentioned

  1. UTI urinary tract infection, rUTI recurrent urinary tract infection, AE adverse event, MS multiple sclerosis