Article Impact Level: HIGH Data Quality: STRONG Summary of JAMA Internal Medicine, 184(6), 619. https://doi.org/10.1001/jamainternmed.2024.0264 Dr. Gail Hayward et al.
Points
- A randomized clinical trial in the UK involving 598 women at 99 primary care centers assessed the effectiveness of d-mannose in preventing recurrent urinary tract infections (UTIs).
- Participants received either 2 grams of d-mannose powder daily or a placebo over six months to evaluate its preventative capabilities against medically attended UTIs.
- The trial found no significant reduction in UTI incidence with d-mannose compared to placebo, with 51.0% of women in the d-mannose group and 55.7% in the placebo group experiencing a UTI, showing a risk difference of -5% (95% CI, -13% to 3%; P = .26).
- Secondary outcomes showed no significant differences between the groups, including symptom duration, antibiotic use, time to next medically attended UTI, number of suspected UTIs, and UTI-related hospital admissions.
- The results indicate that d-mannose does not significantly benefit the prevention of recurrent UTIs in women, highlighting the need for further research and evidence-based preventive measures in managing recurrent UTIs.
Summary
In a robust randomized clinical trial conducted across 99 primary care centers in the UK, researchers investigated the effectiveness of d-mannose in preventing recurrent urinary tract infections (UTIs) in women. This double-masked, placebo-controlled trial included 598 women who had experienced multiple UTIs, as evidenced by their primary care records. Over six months, these participants were administered either 2 grams of d-mannose powder daily or a placebo to assess the prevention capabilities of d-mannose against medically attended UTIs.
The trial outcomes indicated that d-mannose did not significantly reduce the incidence of UTIs compared to the placebo. Specifically, 51.0% of women in the d-mannose group and 55.7% in the placebo group experienced at least one further episode of clinically suspected UTI that led them to seek medical care, with a risk difference of -5% (95% CI, -13% to 3%; P = .26). This marginal difference suggests that d-mannose has limited efficacy in reducing the occurrence of medically attended UTIs among this demographic. Additionally, no significant differences were observed in secondary outcomes, including symptom duration, antibiotic use, time to next medically attended UTI, number of suspected UTIs, and UTI-related hospital admissions.
Based on these findings, d-mannose does not appear to provide a significant benefit for the prophylaxis of recurrent UTIs in women in primary care settings. The trial’s results, therefore, do not support the recommendation of d-mannose for preventing future episodes of UTIs in women with a history of recurrent infections. These conclusions underscore the necessity for further research into effective preventive measures and the importance of evidence-based approaches in managing recurrent UTIs.
Link to the article: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2817488
References Hayward, G., Mort, S., Hay, A. D., Moore, M., Thomas, N. P. B., Cook, J., Robinson, J., Williams, N., Maeder, N., Edeson, R., Franssen, M., Grabey, J., Glogowska, M., Yang, Y., Allen, J., & Butler, C. C. (2024). d-Mannose for Prevention of Recurrent Urinary Tract Infection Among Women: A Randomized Clinical Trial. JAMA Internal Medicine, 184(6), 619. https://doi.org/10.1001/jamainternmed.2024.0264
