D-mannose and Urinary Tract Infections

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About 25 years ago, Dr. Jonathan Wright began using D-mannose, a sugar structurally similar to glucose, to prevent and treat UTIs (urinary tract infections).   His treatment was based on laboratory evidence that D-mannose prevents E. coli bacteria from adhering to the epithelial cells of the genitourinary tract.  In Dr. Wright’s experience, it is effective in 85-90% of patients, with less effectiveness for UTIs caused by organisms other than E. coli.  Many practitioners using D-mannose concur with Dr. Wright’s observations.

A small randomized controlled trial from 2014 confirmed this anecdotal evidence.  Three groups of women with a history of recurrent UTIs received preventive treatment with either D-mannose, an antibiotic (nitrofurantoin), or no preventative treatment (control group).  The UTI recurrence rate was significantly lower in the groups that received D-mannose or the antibiotic.  However, the incidence of side effects was also significantly lower in the D-mannose group compared to the antibiotic group.

Terry Pfau DO, HMD

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