📃 Paper Title: D-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial
🧍 Author: Bojana Kranjcec
🕒 Year: 2013
📚 Journal: World Journal of Urology
🌎 Country: Croatia
ㅤContext to the study:
Can you tell me about a study which assessed the efficacy of D-mannose against administration of low dose antibiotics for the treatment for women with recurrent UTIs?
ㅤ✅ Take-home message of study:
In women with recurrent urinary tract infection, D-mannose taken for 6 months is equally effective as administration of low dose antibiotics (prophylactic Nitrofurantoin).
ㅤ Randomised clinical trial
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Study participants:
Study size:
Number included: 308
Inclusion criteria:
Females > 18 years
History of recurrent cystitis (defined as at least two episodes of acute cystitis in the last 6 months and/or 3 episodes of acute cystitis in the last year)
Exclusion criteria:
Pregnant females, or who are trying to conceive
Patients currently breastfeeding
If clinical features of upper UTI present
Features of SIRS (Systemic Inflammatory Response Syndrome)
Known history of urinary tract anomalies
Diagnosed with Diabetes Mellitus
Previously diagnosed with Interstitial cystitis
Currently on hormone therapy or contraception
Have received antibiotic prophylaxis before
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Key study outcomes:
Definition of UTI = Lower urinary tract symptoms (at least 2 features) and a bacterial count of ≥103 colony- forming units (CFU) in 1 ml of clean voided midstream urine
Outcomes:
Higher number of recurrent cystitis episodes in the group with no prophylaxis [RR 0.335, 95 % CI 0.222-0.506] as compared to the group who received either D-mannose or Nitrofurantoin [ RR 0.239, 95 % CI 0.146-0.392]
Recurrent UTI rates between D-mannose group and Nitrofurantoin group did not differ significantly.
Side effects were experienced by 17.9% patients in the Nitrofurantoin group, although not of severity to result in treatment cessation. Significantly fewer patients in the D-Mannose group experienced side effects (RR 0.276, p<0.001).
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Study Limitations:
Single-centre unblinded study
Total number of recurrent episodes in patients not quantified
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