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Dmn8.5
D-Mannose Research
Likely helpsHigh safety
32 peer-reviewed studies
What the evidence says
Likely helps
D-Mannose appears to help in 8 of 11 studies with measurable effects — the evidence leans clearly favourable.
Most evidence is from high-quality meta-analyses and randomised trials published 2014–2026 with a typical study size of 90 participants.
Based on 32 studies · 3 meta-analyses · 17 RCTs · 21,929 total participants
Confidence
High
What the studies found
8helped3unclear· 21 more without graded effect data
By outcome
Urinary tract infection
Likely helps31 studies
Therapeutic & clinical
Mostly mechanism / observational5 studies
Safety profile
Mostly mechanism / observational4 studies
Women's health
Too few graded studies2 studies
By the numbers
Pulled from 26 studies with measurable effects
Likely real effects
50%
across studies
People studied
22k
typical study: 90 people
Strongest designs
20
3 pooled, 17 randomised
Showed benefit
73%
8/11 studies
How long studies ran
Under a week
1
1–3 months
3
3+ months
4
Populations Studied
High-risk patients (97.6% women)1
Catheter and non-catheter users1
Patients with recurrent UTIs1
Older patients with frailty and recurrent UTI1
Active research area
17 studies in the last 5 years · Latest meta-analysis: 2025
201420202026
1Meta-AnalysisCited 5×n=10,495 · very large study2025
D-mannose, triple therapy, vaccine, probiotics, and cranberry serve as potential nonantibiotic intervention options for clinical UTI prevention.
Han Z et al. · Infection (2025)
Nearly 80% of the RCTs utilized double-blind or triple-blind designs.
D-mannose, triple therapy, vaccine, probiotics, and cranberry serve as potential nonantibiotic intervention options for clinical UTI prevention.
2Incidence of recurrent UTIsMeta-Analysisn=1,167 · large study2025
In this meta-analysis of RCTs, D-mannose did not reduce the incidence of recurrent UTIs compared with control or antibiotics in high-risk patients.
Vargas CEF et al. · Jornal brasileiro de nefrologia (2025)
No clear effect
← WorseNo effectBetter →
Likely real
We included 6 RCTs comprising 1,167 participants, of whom 534 received D-mannose and 521 (97.6%) were women.
D-mannose was not associated with a reduction in recurrent UTI compared with control (RR: 0.57, 95% CI 0.29 - 1.15; p < 0.01) or antibiotics (RR: 0.39, 95% CI 0.12 - 1.25; p < 0.01).
In this meta-analysis of RCTs, D-mannose did not reduce the incidence of recurrent UTIs compared with control or antibiotics in high-risk patients.
Prophylactic antibiotic use may reduce recurrence in selected patients but carries significant risks, including Clostridioides difficile infection and antimicrobial resistance.
Clinical decision-making should be guided by individualized risk assessment, careful consideration of treatment burden, and regular reassessment of both benefits and harms.
Further research is urgently needed to inform evidence-based prevention strategies for this vulnerable population.
Additional clinical trials are warranted to validate the therapeutic efficacy and durability of these techniques.
Chen YC et al. · International journal of molecular sciences (2023)
Even without underlying anatomic or functional abnormalities, more than 40% of women experience at least one UTI in their lifetime, of which 30% develop recurrent UTIs (rUTIs) within 6 months.
The adaptive evolution of UPEC has been observed in several aspects, including colonization, attachment, invasion, and intracellular replication to invade the urothelium and survive intracellularly.
Combination therapies targeting multiple pathogenic mechanisms are expected to be a future trend in UTI management, although some of these treatment options have not been well established in terms of their long-term efficacy.
7Urinary tract infection prophylaxis efficacySystematic ReviewCited 1×n=24 · very small study2023
For those who are interested in trying these products despite the lack of robust evidence for clinical efficacy, it may be helpful to know that the studies included in this review did not identify any clinically important signs of harm, to the extent that safety data were documented and reported.
Song G et al. · The Senior care pharmacist (2023)
This review captured all studies in previous reviews as well as recent publications.
Conclusions The three supplements reviewed appear not to be strongly supported by clinical data.
For those who are interested in trying these products despite the lack of robust evidence for clinical efficacy, it may be helpful to know that the studies included in this review did not identify any clinically important signs of harm, to the extent that safety data were documented and reported.
9D-mannose effects on urinary tract infectionsSystematic ReviewCited 41×2022
This systematic-review examined the effects of D-Mannose.
Ala-Jaakkola R et al. · Nutrition journal (2022)
When excreted in urine, D-mannose potentially inhibits Escherichia coli, the main causative organism of UTIs, from attaching to urothelium and causing infection.
In this review, we provide an overview of UTIs, E. coli pathogenesis and D-mannose and outline the existing clinical evidence of D-mannose in reducing the risk of UTI and its recurrence.
Furthermore, we discuss the potential effect mechanisms of D-mannose against uropathogenic E.coli.
A combination of these agents might provide the optimal treatment to reduce recurrent UTI, and trials in specific population groups are required.
Sihra N et al. · Nature reviews. Urology (2018)
The growing problem of antimicrobial resistance means that the search for nonantibiotic alternatives for the treatment and prevention of UTI is of critical importance.
Some of the results of trials of these approaches are promising; however, high-level evidence is required before firm recommendations for their use can be made.
A combination of these agents might provide the optimal treatment to reduce recurrent UTI, and trials in specific population groups are required.
11Recurrent urinary tract infection pathogenesis and preventionSystematic ReviewCited 12×2020
Urinary tract infections are highly prevalent among women and when they are recurrent they can lead to patient discomfort and high healthcare costs, and they represent one of the most frequent caus...
Pigrau C et al. · Medicina clinica (2020)
Urinary tract infections are highly prevalent among women and when they are recurrent they can lead to patient discomfort and high healthcare costs, and they represent one of the most frequent causes of antibiotic consumption.
The last 20 years of research on non-antibiotic approaches in UTI have not brought conclusive evidence that antibiotic usage can be replaced completely by non-antibiotic options.
Wawrysiuk S et al. · Archives of gynecology and obstetrics (2019)
The last 20 years of research on non-antibiotic approaches in UTI have not brought conclusive evidence that antibiotic usage can be replaced completely by non-antibiotic options.
Hence, antibiotics still remain a gold standard for UTI treatment and prevention.
However, changing the therapeutic strategy by including non-antibiotic measures in the management of UTI could be successful in avoiding antimicrobial resistance at least to some extent.
16Proportion with subsequent clinically suspected UTIRCTCited 42×n=7,591 · very large study2024
In this randomized clinical trial, daily d-mannose did not reduce the proportion of women with recurrent UTI in primary care who experienced a subsequent clinically suspected UTI. d-Mannose should not be recommended for prophylaxis in this patient group.
Hayward G et al. · JAMA internal medicine (2024)
No clear effect
← WorseNo effectBetter →
Could be chance
Of 598 women eligible (mean [range] age, 58 [18-93] years), 303 were randomized to d-mannose (50.7%) and 295 to placebo (49.3%).
Primary outcome data were available for 583 participants (97.5%).
The proportion contacting ambulatory care with a clinically suspected UTI was 150 of 294 (51.0%) in the d-mannose group and 161 of 289 (55.7%) in the placebo group (risk difference, -5%; 95% CI, -13% to 3%; P = .26).
Combining fosfomycin and an integrated D-mannose supplement for managing rUTIs offers a potential reduction in antibiotic reliance.
Riemma G et al. · Expert review of anti-infective therapy (2025)
Huge benefit
← WorseNo effectBetter →
Borderline
Combination therapy had lower number of women matching rUTI criteria (55.32% vs 76.47% and 84%; p < 0.05) and symptoms remission at 12 months (89.36% vs 56.86% and 20%; p < 0.001).
Combining fosfomycin and an integrated D-mannose supplement for managing rUTIs offers a potential reduction in antibiotic reliance.
Further large-scale studies are recommended to confirm these findings.
UroBest has a favorable efficacy and safety profile.
Kyzlasov P S et al. · Urologiia (Moscow, Russia : 1999) (2024)
Administration of complex preparations with extracts of medicinal plants as an additional to antibacterial therapy led to significant improvement of all parameters, except for the level of leucocytes in the complete cell count.
UroBest has a favorable efficacy and safety profile.
Further research warranted to confirm findings
19Incidence of UTI after cystoscopyRCTCited 1×n=32 · small study2023
Conclusions: D-Mannose plus Saccharomyces boulardii administered after cystoscopy seem to significantly reduce the incidence of UTI, the severity of LUTS, and the intensity of local discomfort.
Quattrone C et al. · Medicina (Kaunas, Lithuania) (2023)
Large benefit
← WorseNo effectBetter →
Likely real
No urine culture was positive in Group A 7 days after cystoscopy, while 3 patients (18.8%) in Group B had a positive control urine culture (p = 0.044).
At 7 days after cystoscopy, the median IPSS of Group A was significantly lower than that of Group B (10.5 vs. 16.5 points; p = 0.021), and at 7 days, the median NRS for local discomfort/pain of Group A was significantly lower than that for Group B (1.5 vs. 4.0 points; p = 0.012).
No statistically significant difference (p > 0.05) in the median IPSS-QoL and EORTC QLQ-C30 was found between groups.
20Recurrent urinary tract infection preventionRCTCited 9×n=184 · medium study2020
The oral taking of a daily sachet of Manosar® is effective and safe in preventing recurrent UTIs in women, being superior to the oral taking of isolated PAC.
Salinas-Casado J et al. · Archivos espanoles de urologia (2020)
Likely real
A total of 72 patients suffered an UTI due to E.coli: 25 patients in the arm with Manosar® versus 47 patients in the isolated PAC group, this difference being statistically significant (p=0.002).
The oral taking of a daily sachet of Manosar® is effective and safe in preventing recurrent UTIs in women, being superior to the oral taking of isolated PAC.