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D-MannosE to prevent Recurrent urinary tract InfecTions (MERIT): protocol for a randomised controlled trial
Marloes Franssen1, Johanna Cook2, Jared Robinson2
1Nuffield Department of Orthopaedics, Rheumathology and Musculoskeletal Sciences, University of Oxford, Oxford, Oxfordshire, UK.
BMJ Open
|January 14, 2021
Summary
D-mannose shows promise in preventing recurrent urinary tract infections (RUTIs) by inhibiting bacterial adherence. The MERIT study will assess its clinical and cost-effectiveness compared to placebo in women with RUTIs.
Area of Science:
- Urology
- Infectious Diseases
- Pharmacology
Background:
- Recurrent urinary tract infections (RUTIs) significantly impact quality of life and healthcare costs.
- Daily prophylactic antibiotics are the current standard for UTI prevention, but alternatives are sought.
- D-mannose, a sugar, is hypothesized to prevent RUTIs by inhibiting bacterial adherence to uroepithelial cells.
Purpose of the Study:
- To evaluate the clinical and cost-effectiveness of D-mannose in reducing UTI frequency and symptom burden.
- To assess D-mannose as a preventative measure for women experiencing RUTIs in UK primary care.
Main Methods:
- A two-arm, individually randomised, double-blind, placebo-controlled, pragmatic trial (MERIT study).
- 508 participants randomised to receive daily D-mannose powder or placebo for 6 months.
- Primary outcome: number of medical attendances for RUTI symptoms; secondary outcomes include UTI incidence, symptom days, quality of life, and healthcare utilisation.
Main Results:
- The study is designed with 90% power to detect a 50% reduction in RUTI recurrence.
- A within-trial economic evaluation will determine the cost-effectiveness of D-mannose.
- A nested qualitative study will explore participant experiences.
Conclusions:
- Rigorous evidence is needed to guide D-mannose use for RUTI prevention.
- The MERIT study aims to provide robust data on D-mannose efficacy and cost-effectiveness.
- Publication of findings is anticipated in 2021.
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