Safety and Efficacy of D-mannose as Prophylaxis of Urinary Tract Infection: A Systematic Review and Meta-Analysis
Abstract
Introduction: Urinary tract infection (UTI) is the most common bacterial infection, with over 404.6 million cases and more than 230,000 deaths in 2019. Recurrent UTIs significantly impact quality of life due to symptoms, avoidance of sexual activity, persistent pain, and recurrent antibiotic use. A previous meta-analysis suggested the efficacy of D-mannose for UTI prophylaxis, but recent stronger evidence contradicts these findings. This systematic review and meta-analysis aimed to evaluate the efficacy of D-mannose for preventing recurrent UTI. Methods: Inclusion criteria were prospective randomized studies comparing D-mannose with control or antibiotics in high-risk populations for recurrent UTIs. We excluded abstracts, multi-interventional treatments including D-mannose, and studies using D-mannose for current UTI treatment rather than prophylaxis. The primary outcome was recurrent UTI, analyzed using relative risk (RR) and 95% confidence intervals (CI). Results: We searched EMBASE, MEDLINE, and the Cochrane Library, identifying 958 articles and abstracts, with 853 remaining after deduplication. We selected 34 for full-text review and included 6 studies. These studies involved 534 patients treated with D-mannose, of whom 521 (97.6%) were women. D-mannose was not associated with a reduction in recurrent UTI compared to control (RR: 0.57, 95% CI 0.28-1.16; p< 0.01) or antibiotics (RR: 0.39, 95% CI 0.12-1.25; p< 0.01). Further analyses showed D-mannose did not reduce time to…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 534 participants or records.
Read the paper
Related studies
- Association of lower urinary tract symptoms and OAB severity with quality of life and mental health in China, Taiwan and South Korea: results from a cross-sectional, population-based study
- Ten-Day Quadruple Therapy Comprising Low-Dose Rabeprazole, Bismuth, Amoxicillin, and Tetracycline Is an Effective and Safe First-Line Treatment for Helicobacter pylori Infection in a Population with High Antibiotic Resistance: a Prospective, Multicenter, Randomized, Parallel-Controlled Clinical Trial in China
- The Role of the NLR and PLR in Urinary Tract Infection
- Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic
- Leclercia adecarboxylata urinary tract infection in a patient with bladder cancer and recurrent hematuria
- A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.