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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