📃 Paper Title: D-mannose vs other agents for recurrent urinary tract infection prevention in adult women: a systematic review and meta- analysis
🧍 Author: Lenger S. M.
🕒 Year: 2020
📚 Journal: American Journal of Obstetrics & Gynecology
🌎 Country: United States of America
ㅤContext to the study:
Can you tell me about a study that showed a valid alternative to antibiotics for recurrent UTIs?
ㅤ✅ Take-home message of study:
D-mannose shows:
Higher protection from recurrent UTIs compared to placebo
Similar effectiveness as antibiotics, with less side effects
Good tolerability and compliance, although limited data
ㅤ Systematic review and meta-analysis
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Study participants:
Participants:
Inclusion in the systematic review (8 studies):
Women ≥18 years old with recurrent UTI (≥ 2 UTI in 6 months or ≥ 3 UTIs in 12 months) which D-mannose was utilized as an outpatient prevention regimen (databases searched on 5th February 2018, 5th March 2019 and 15th April 2020)
Randomized controlled trials (RCT), cross-over trials, prospective and retrospective cohorts
English language
Inclusion in the meta-analysis (3 studies, sample sizes ranging from 43 to 308 participants):
D-mannose dosing stated
Follow-up time ≥ 6 months
Presence of a comparator arm
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Key study outcomes:
Outcomes:
(1) Effectiveness of D-mannose compared to other agents for recurrent UTI prevention in adult women:
overall relative risk (RR) of recurrent UTI for patients on D-mannose compared to placebo varied from 0.14 to 0.24
overall RR of recurrent UTI for patients on D-mannose compared to prophylactic antibiotics varied from 0.22 to 0.71 (overall RR 0.39, CI 0.12-1.25)
The meta-analysis of D-mannose versus antibiotics: had an I2 of 88%
(2) Side effects and compliance with D-mannose use:
Safe profile (low incidence of mild to moderate gastrointestinal side effects)
Good compliance (limited data)
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Study Limitations:
Small number of studies with varied study design and quality;
overall small sample size
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