Use of D-mannose in the prevention of recurrent lower urinary tract infection in women


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Abstract

Lower urinary tract infections (LUTI) currently retain the status of one of the most urgent problems of urology. According to extensive microbiological studies of UTIAP I and II, «DARMIS» the most common pathogens that are detected in the urine of women with LUTI are gramnegative bacteria of the Enterobacteriales family, in particular E. Coli. Antibacterial therapy demonstrates high effectiveness in the treatment of uncomplicated LUTI. However, the problem of recurrent infection remains unresolved. Taking into account known side effects of continuous antimicrobial prevention, as well as data on the high frequency of relapses after its cancellation, it is necessary to identify alternative LUTI prevention strategies. The use of D-mannose can be one of these strategies. D-mannose use for the prevention of relapses of INMP is indicated in the clinical recommendations of the American (AUA) and European (EUA) urological associations. D-mannose is a monosaccharide that is extracted from a larch rod. It is relatively quickly absorbed and reaches the peripheral organs in about 30 minutes, after which it is excreted in the urine. The structure of d-mannose allows it to bind to mannose-sensitive E. Coli fimbriae and prevent their adhesion to the urinary tract mucosa. Several studies demonstrated high safety profile and effectiveness of longterm D-mannose treatment in preventing LUTI. The data presented in the literature allow us to recommend patients with recurrent LUTI long term D-mannose intake helps to reduce the severity of symptoms in acute episodes and prolong relapse-free period. As a source of D-mannose, we can recommend Ecocystin 1 sachet 1 time a day.

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About the authors

A. V Kuzmenko

Voronezh State Medical University n.a. N.N. Burdenko

Email: Kuzmenkoav09@yandex.ru
MD, professor, Head of Department of Urology Voronezh, Russia

V. V Kuzmenko

Voronezh State Medical University n.a. N.N. Burdenko

Email: kuzmenkovv2003@mail.ru
MD, professor at the Department of Urology Voronezh, Russia

T. A Gyaurgiev

Voronezh State Medical University n.a. N.N. Burdenko

Email: tima001100@mail.ru
Ph.D., associate professor at the Department of Urology Voronezh, Russia

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