August 2022 Article in Biomedical Reports entitled “Systematic review of the effect of D-mannose with or without other drugs in the treatment of symptoms of urinary tract infections/cystitis”
Authors: Fabio Parazzini, Elena Ricci, Francesco Fedele, Francesca Chiaffarino, Giovanna Esposito, and Sonia Cipriani
Summary: Several studies, reviews and meta-analyses have documented that D-mannose use lowers the risk of recurrent urinary tract infections (UTI), but its role in the treatment of UTI/cystitis-related symptoms is unclear. In this paper, we systematically reviewed the published data on the effect of D-mannose, alone or in association with other compounds, on the typical symptoms of UTI/cystitis. PubMed/Medline and EMBASE databases were searched, from 1990 to January 2022.
Key Findings On Treatment of Cystitis Symptoms: All studies reported that symptoms decreased after treatment with D-mannose. Despite the limitations of the studies, the consistent results observed among all studies give support to the general findings that D-mannose may be useful in the treatment of UTI/cystitis symptoms.
Additional Findings On Long-Term Effects of D-Mannose: At least 90% of ingested D-mannose is absorbed in the upper part of the intestine. Its peculiarity is that despite it being a simple molecule, this sugar is not metabolized by the organism. Consequently, it is not stored in the liver or other organs, but it is excreted unconverted into the urine via the kidneys. About 60 min after ingestion, it arrives unchanged in the urinary tract. D-mannose also has no effect on human metabolism after long-term use.
Furthermore, it has been suggested that the dosages of D-mannose used in clinical practice does not affect E. coli metabolism and growth and does not modify bacterial adhesiveness causing FimH variants. All these characteristics underline the fact that the long term use of D-mannose is safe.
March 2022 article in the Nutrition Journal entitled “Role of D-Mannose in Urinary Tract Infections – A Narrative Review”
Authors: Reeta Ala-Jaakkola, Arja Laitila, Arthur C. Ouwehand, Liisa Lehtoranta
Summary: In addition to female gender, sexual activity at young age and higher age in general, specific conditions such as diabetes, neurologic conditions, chronic institutional residence, and chronic urinary catheterization might predispose to recurring UTIs (rUTIs).
Therefore, individuals in need of repetitive antibiotic treatments, going through urogenital procedures or women with changed bacterial environment in the urogenital area would benefit the most from a non-antibiotic alternative.
Due to increasing antibiotic resistance among UTI pathogens, the burden caused by UTIs is expected to increase creating a high demand for alternative options.
For the treatment of acute UTI, antibiotics are likely to remain the first choice. Supplementing antibiotics with D-mannose may increase treatment success. However, for prophylaxis in reducing rUTI, D-mannose appears to have great potential with minimal side effects.
April 2021 article in the Antibiotics Journal entitled “The Role of D-Mannose in Prevention of Recurrent Uncomplicated Cystitis: State of The Art and Future Perspectives”
Authors: Cosimo De Nunzio, Riccardo Bartoletti, Andrea Tubaro, Alchiede Simonato, and Vincenzo Ficarra
Summary: Particularly, our findings support and confirm that D-mannose reduces the incidence of rUTIs (recurrent UTIs) and determines a longer interval between UTI episodes, with a significant improvement in patients’ quality of life, and therefore, its administration could be considered as one of the possible strategies to be used or to be investigated for the prevention of recurrent UTI in women.