Date of Award

Spring 5-2025

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Andvik, Vicki

Second Advisor

Kauffman, Russ

Keywords

urinary tract infection, recurrence, D-mannose, and prophylaxis

Abstract

Recurrent urinary tract infections (rUTIs) are a significant health concern for women, affecting their quality of life and requiring effective and safe prophylactic and therapeutic interventions. This literature review evaluates the efficacy, safety, and mechanisms of D-mannose, a natural sugar, in preventing and treating UTIs. This review is based on a structured search and selection of randomized controlled trials and pilot studies identified through databases such as PubMed, Embase, and Google Scholar. Evidence from assorted studies, including randomized controlled trials and pilot research, indicates that D-mannose may reduce UTI recurrence rates and alleviate acute symptoms with comparable efficacy to standard antibiotics. Daily D-mannose demonstrated a significant reduction in recurrence rates for prophylaxis compared to placebo and nitrofurantoin, with fewer adverse effects. In acute UTI management, D-mannose-based supplements improved symptom resolution and achieved bacteriological clearance more effectively than placebo. Mechanistically, D-mannose prevents uropathogenic Escherichia coli (UPEC) from adhering to bladder cells, interrupting infection progression without promoting bacterial resistance. Despite promising results, limitations such as small sample sizes, lack of long-term follow-up, and variable study designs warrant further large-scale, blinded trials to establish standardized dosing regimens and confirm efficacy. Overall, D-mannose represents a potential alternative or adjunct in UTI management, emphasizing a need for continued research into its clinical applications.

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