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Table 2 Clinical trials in acute UTI/rUTIs with treatment supplementations including D-mannose and probiotics

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

Reference Study Design Subjects and groups Supplementation Main Findings (including safety)
Del Popolo 2018 [71] Pilot study, non-randomized 68 women and 17 men affected by recurrent symptomatic cystitis. Of those, 33 women and 13 men suffered from neurogenic bladder
n = 85
Acute: 5-days bid 1000 mg of D-mannose, 200 mg of dry willow extract (salicin) (attack phase), followed by 7-days bid with 700 mg of D-mannose plus 50 mg (109 CFU) of L. acidophilus La-14 (maintenance treatment).
Long term: The maintenance treatment was repeated for 15 days every month for the next two months.
Combination treatment was effective in acute UTI and as prophylaxis
No significant AEs reported
Milandri 2018 [72] Single-center, single-arm, uncontrolled observational study 19–87-year-old female patients who underwent urodynamic invasive procedure
n = 100
Long-term: After invasive surgery, 14-days bid 1000 mg D-mannose, 200 mg H. sabdariffa, and 109 CFU L. plantarum Lp-115 Risk of bacteriuria and UTI in women could be reduced with the studied product
No AEs
Murina 2020 [73] Single-center Premenopausal women aged 18–50 years with an acute UTI and a history of recurrent uncomplicated UTIs
n = 55
After 2 days Fosfomycin (3 g once a day) the following combination treatment: Lactoflorene Cist® including 109 CFU L. paracasei LC11, cranberry extract and 1000 mg D-mannose:
Group 1: once a day for 10 days/month for 90 days (n = 19)
Group 2: once a day for 90 days (n = 19)
Group 3: No treatment (n = 17)
Both treatments efficient and safe as prophylaxis for rUTIs.
No AEs
Vicariotto 2014 [74] A pilot prospective study Premenopausal, nonpregnant women diagnosed with acute uncomplicated cystitis
n = 33
Acute: For 30 days 2 doses a day
Long-term: after 30 days acute phase, 1 dose a day until day 60
Dose: 2.5 × 109L. plantarum LP01 and 1 billion L. paracasei LPC09 and S. thermophilus ST10, 250 mg of tara gum, 500 mg of a high proanthocyanidins cranberry extract and 250 mg of D-mannose
Significant improvement in the UTI symptoms (dysuria, frequent voiding, urgency, and suprapubic pain) in long-term
No AEs mentioned
  1. UTI urinary tract infection, rUTI recurrent urinary tract infection, AEs adverse events, CFU colony forming units, bid two times a day