MERIT
Trial question
What is the role of D-mannose prophylaxis in women with recurrent UTI?
Study design
Multi-center
Double blinded
RCT
Population
598 female patients.
Inclusion criteria: adult women with recurrent UTI.
Key exclusion criteria: pregnancy/lactation; interstitial cystitis or overactive bladder syndrome; nursing home resident; catheterization; use of Uromune.
Interventions
N=303 D-mannose (2 g daily D-mannose powder).
N=295 placebo (daily similar volume of fructose powder).
Primary outcome
Proportion of women with a clinically suspected urinary tract infection within 6 months
51%
55.7%
55.7 %
41.8 %
27.9 %
13.9 %
0.0 %
D-mannose
Placebo
No significant
difference ↔
No significant difference in the proportion of women with a clinically suspected UTI within 6 months (51% vs. 55.7%; RR 0.92, 95% CI 0.8 to 1.05).
Secondary outcomes
No significant difference in mean number of clinically suspected UTIs (0.9 vs. 1; IRR 0.88, 95% CI 0.72 to 1.08).
No significant difference in mean number of microbiologically proven UTIs (0.4 vs. 0.4; IRR 0.97, 95% CI 0.63 to 1.48).
No significant difference in reported consumption of antibiotics (36.3% vs. 43.9%; RR 0.83, 95% CI 0.66 to 1.04).
Safety outcomes
No significant difference in hospitalizations related to UTI.
Conclusion
In adult women with recurrent UTI, D-mannose was not superior to placebo with respect to the proportion of women with a clinically suspected UTI within 6 months.
Reference
Gail Hayward, Sam Mort, Alastair D Hay et al. d-Mannose for Prevention of Recurrent Urinary Tract Infection Among Women: A Randomized Clinical Trial. JAMA Intern Med. 2024 Jun 1;184(6):619-628.
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