D-mannose for preventing and treating urinary tract infections

Area of Science:

• Urology
• Infectious Diseases
• Pharmacology

Background:

• Urinary tract infections (UTIs) are common, with 15-25% of individuals experiencing chronic symptoms.
• D-mannose, a sugar, prevents bacterial adherence to uroepithelial cells, potentially reducing UTI occurrence.
• Existing pilot studies suggest possible efficacy, but robust clinical trials are limited.

Purpose of the Study:

• To assess the benefits and harms of D-mannose for preventing and treating UTIs in adults and children.

Main Methods:

• Searched the Cochrane Kidney and Transplant Register for relevant studies up to February 2022.
• Included randomized controlled trials (RCTs) evaluating D-mannose for UTI prevention or treatment in any population.
• Assessed study quality using the Cochrane risk of bias tool and certainty of evidence with GRADE.

Main Results:

• Seven RCTs (719 participants) were included; however, studies were not comparable, precluding meta-analysis.
• Individual studies reported no clear evidence for D-mannose efficacy compared to placebo or antibiotics.
• Evidence quality was very low due to high risk of bias, sparse data, and small sample sizes; adverse events were minimal and not serious.

Conclusions:

• There is currently insufficient evidence to support or refute D-mannose for UTI prevention or treatment.
• A significant lack of high-quality RCTs hinders definitive conclusions on D-mannose efficacy.
• Future research should prioritize adequately powered RCTs comparing D-mannose with placebo for UTIs.