Abstract: TH-PO117
Safety and Efficacy of D-mannose as Prophylaxis of Urinary Tract Infection: A Systematic Review and Meta-Analysis
Session Information
- Pharmacology
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)
- 2000 Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)
Authors
- Mutarelli, Antonio Marcondes, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Franca Vargas, Carlos Eduardo, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Menegardo Siqueira de Oliveira, Luís Gustavo, Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria, Vitoria, ES, Brazil
- Silva, Acza Kalica Buarque da, Universidade Federal de Alagoas, Maceio, Brazil
- Vieira, Patrícia Rocha Barros, Universidade Estadual de Campinas, Campinas, SP, Brazil
- Da Luz, Jiandra, Universidad Nacional de la Plata, La Plata, Argentina
- Santos Pinto, Luis Claudio, Centro Universitario da Amazonas, Manaus, Brazil
Background
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 as new evidence emerges further analysis can be conducted. This systematic review and meta-analysis aimed to evaluate the efficacy of D-mannose for preventing recurrent UTIs.
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 0.29-1.15; p<0.01) or antibiotics (RR: 0.39, 95% CI 0.12-1.25; p<0.01). Further analyses showed that D-mannose did not reduce time to recurrence of UTI and did not improve outcomes in postmenopausal women.
Conclusion
D-mannose does not reduce recurrent UTIs compared to control or antibiotics and it should not be recommended as prophylaxis. Further studies should target different populations to enhance the sample size, including postmenopausal women.