Supplementing antibiotics with D-mannose enhances UTI treatment, says study

Finland: Antibiotics are likely to remain the first choice for the treatment of acute urinary tract infections (UTIs), according to findings from a narrative review published in Nutrition Journal. Treatment success may be increased by supplementing antibiotics with D-mannose. However, for prophylaxis in reducing UTI recurrence, D-mannose appears to have great potential with minimal side effects.

Urinary tract infections (UTIs) are one of the most prevalent bacterial diseases worldwide."A non-antibiotic alternative would be most beneficial for individuals in need of repetitive antibiotic treatments, going through urogenital procedures, or women with a changed bacterial environment in the urogenital area," Arthur C. Ouwehand, Health & Biosciences, International Flavors & Fragrances, Kantvik, Finland, and colleagues wrote in their study. "Due to increasing antibiotic resistance among UTI pathogens, the burden caused by UTIs is expected to increase resulting in high demand for alternative options."

D-mannose is commonly marketed as a dietary supplement for reducing the risk for UTIs. It is a monosaccharide naturally found in fruits. Investigations have suggested that supplemented D-mannose be a promising alternative or complementary remedy, especially as a prophylaxis for recurrent UTIs. D-mannose potentially inhibits Escherichia coli (the main causative organism of UTIs) from attaching to urothelium and causing infection, when excreted in urine> 

In the review, Dr. Ouwehand and the team aimed to examine the current evidence on the role of D-mannose against UTI. They provided an overview of UTIs, E. coli pathogenesis, and D-mannose and outline the existing clinical evidence of D-mannose in reducing UTI risk and its recurrence. Furthermore, the potential effect mechanisms of D-mannose against uropathogenic E.coli were also discussed. 

"The overall picture of preclinical and clinical studies with D-mannose in the management of UTI is favorable, as discussed here and in a recent narrative review by De Nunzio et al, the authors concluded. "D-mannose has also been shown to be relatively safe and well-tolerated."

Reference:

Ala-Jaakkola, R., Laitila, A., Ouwehand, A.C. et al. Role of D-mannose in urinary tract infections – a narrative review. Nutr J 21, 18 (2022). https://doi.org/10.1186/s12937-022-00769-x