Prospects for using D‑mannose in the prevention and treatment of urinary tract infection in women

Belyi L.E.

Ulyanovsk State University, Ulyanovsk, Russia
Today it is known that approximately half of all women during their lifetime will have at least one episode during their lifetime, and 27% to 48% among them will experience recurrent infection episodes in the future. The recent guidelines of international urology associations, as well as the summarized results of researches in the past years emphasize the advisability of the limited use of antibiotics in urinary tract infections, which is due to the constant increase in antibiotic resistance of uropathogens. Under these conditions, the promising area in the prevention and treatment is to use D-mannose, a monosaccharide that is excreted unchanged from the body with urine, where it competitively inhibits bacterial cell adhesion to the urothelium, by creating a biomechanical barrier.
This review gives new scientific data concerning the mechanisms of adhesion of E. coli to the umbrella cells of the urothelium; describes the key features of the pharmacokinetics of D-mannose in the human body, its role in countering E. coli adhesion to the mucous membrane of the urinary tract. The paper presents the results of experimental studies establishing that it is advisable to use D-mannose in urinary tract infection. It analyzes the clinical trials, the results of which demonstrate that the prevention of urinary tract infections in women with D-mannose is highly competitive with the prophylactic use of antibiotics. The today’s concept of the pathogenesis of urinary tract infection in women presumes that urobioma damage precedes symptomatic infection. In this connection, the paper analyzes the intermediate results of combined prophylactic use of D-mannose in women and some Lactobacillus species.
Conclusion: The use of D-mannose may become a promising area in the prevention and treatment of urinary tract infection in women who have no contraindications or apparently side effects.

Conflict of interest: The author declares that there are no conflicts of interest.
Funding: The investigation has not been sponsored.
For citation: Belyi L.E. Prospects for using D-mannose in the prevention and treatment of urinary tract infection in women.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (5): 21-28 (in Russian)


иrinary tract infection
antibiotic resistance


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Received 14.12.2022

Accepted 30.03.2023

About the Authors

Lev E. Belyi, Dr. Med. Sci., Professor at the Department of Hospital Surgery, Anesthesiology, Reanimatology, Urology, Traumatology, Orthopedics, Ulyanovsk State University, +7(917)605-97-19,,, 432017, Russia, Ulyanovsk, Leo Tolstoy str., 42.

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