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  1. Jalesh Panicker,
  2. Véronique Phé,
  3. Mahreen Pakzad,
  4. Collette Haslam,
  5. Gwen Gonzales,
  6. Carmel Curtis,
  7. Bernadette Porter,
  8. Jeremy Chataway
  1. The National Hospital for Neurology and Neurosurgery


Introduction Urinary tract infections (UTIs) are a significant problem in Multiple sclerosis (MS). D-mannose is a natural supplement shown recently to prevent UTIs, however benefits in multiple sclerosis (MS) are unknown.

Objective To evaluate feasibility of using D-Mannose in MS patients reporting recurrent UTIs.

Methods In this prospective single-centre, open-label study, participants were given D-mannose (Nature upplies Ltd, UK) 1.5 grams twice daily for 16-weeks and compliance recorded. Training was provided for recognising UTIs and self-monitoring using urine reagent-strip dipsticks. Results of dipsticks and cultures when UTIs were suspected, and antibiotic prescriptions, were recorded.

Results Median compliance of 22 patients (18 females; median age 50 years (46–59), (group 1 not using catheters (n=10); group 2 catheter-users (n=12)) using D-Mannose was 100%; no adverse events were reported. In total, there were 61 episodes of suspected UTIs and 29 prescriptions for antibiotics. In group 1, median number of prescriptions was 1 (0–2.2) and culture-proven symptomatic UTIs 0.5 (0–1) and in group 2, 2 (0–3) prescriptions and 1 (0–2) culture-proven UTIs. Number of monthly UTIs significantly decreased in both groups (p<0.01).

Conclusion The use of D-mannose in MS patients reporting recurrent UTIs is associated with a reduction in the number of UTIs and antibiotic prescriptions, without safety concerns. Larger studies are required to confirm efficacy.

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