New Study Reveals D-Mannose Ineffective in Preventing Recurrent Urinary Tract Infections

In the quest to find non-antibiotic prophylactics for recurrent urinary tract infections (UTIs), a new study published in JAMA Internal Medicine has found that daily D-Mannose, a popular supplement, does not significantly reduce the rate of infection among women in primary care settings.

Conducted across 99 UK primary care centers, the randomized, double-blind, placebo-controlled trial followed 598 women for six months. Despite prior evidence pointing toward the potential of D-Mannose, which is found in small quantities in certain fruits, the study found no significant difference in preventing UTIs between the group taking the supplement and the placebo group.

Recurrent UTI, defined as two or more occurrences within six months or three within a year, greatly impacts women's quality of life. Current approaches to prevention largely revolve around antibiotic use, contributing to the development of antibiotic-resistant strains and adverse side effects. This has led to an exploration of alternative strategies, such as the use of D-Mannose, a sugar that is thought to inhibit bacterial adherence to the urinary tract lining.

Participants were split into two groups, with 303 receiving two grams of D-Mannose powder daily and 295 receiving a placebo. Study metrics focused on the number of clinically suspected UTI episodes leading to ambulatory care visits within a six-month follow-up period. Secondary outcomes included symptom duration, antibiotic use, hospital admissions, and microbiologically proven UTIs.

The results were revealing – 51.0% in the D-Mannose group and 55.7% in the placebo group experienced at least one medically attended UTI episode, a difference that was not statistically significant. Moreover, there were no substantial differences in secondary outcomes, such as the number of UTIs, hospital admissions, or antibiotic consumption.

Given D-Mannose's cost – at least £23 monthly in the UK – and over-the-counter availability, the implications of these findings hold great significance. For women with recurrent UTI consulting primary care, this study suggests that D-Mannose should not be recommended as an effective prophylaxis.

This trial, registered at isrctn.org (Identifier: ISRCTN13283516), stands out with its extensive design and rigorous conduct, increasing confidence in the results. Though it does not support the use of D-Mannose for UTI prevention in primary care, the study contributes essential insights into the ongoing struggle against this pervasive health issue.

For more details, the full study can be accessed in JAMA Internal Medicine, published online April 8, 2024, or by visiting the journal's website at jamanetwork.com.

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