Table 2.

Studies reviewed by endpoint and adverse events

	Endpoint	Mean duration of follow-up	Efficacy comparison	Safety data (adverse effect)	Treatment compliance	Conclusion
Kranjcec, et al.[21,22]	The number of patients in each group without recurrent UTI after 6 months	6 months	85.4% in D-mannose powder group; 79.6% in nitrofurantoin group; 39.2% in placebo group; P=0.001	There is eight patient in D-mannose group (7.8%) versus 29 patients in nitrofurantoin group (27.2%)	100% compliance rate for all groups	D-mannose powder shown effective in preventing UTI during 6-month prophylaxisThe recurrence rate did not differ between the patient taking standard prophylaxis and those who took D-mannose powder
McMurdo, et al.[22]	Symptomatic UTI treated by the GP	6 months	64% in cranberry group; 79% in TMP-SMX group; P=0.084	Six patients in cranberry group (9%)Eleven patients in the trimethoprim group (16%)	91% from the cranberry group; 84% from the trimethoprim group	Trimethoprim had a very limited advantage over cranberry extract in the prevention of recurrent UTIs in older women and had more adverse effects
Beerepoot et al.[23]	The mean number of symptomatic UTIs over 12 months	12 months	29% in TMP-SMX group; 21.8% in cranberry group	Five patients in TMP-SMX group (4.5%)Six patients in cranberry group (5.4%)	45.5% for TMP-SMX group; 45.2% for cranberry group	In premenopausal women with rUTIs, TMP-SMX, 480 mg once daily, is more effective than cranberry capsules, 500 mg twice daily, for the prevention of rUTIs
Raz, et al.[24]	Absence of symptomatic/asymptomatic episodes of bacteriuria	9 months	32.6% in estriol group; 48.2% in NM group; P=0.01	10.5% in estriol group (nine patients) and 16.5% in NM group (fourteen patients)	93.0% for estriol group; 87.0% for NM group	Use of the estriol-containing vaginal pessary studied here failed to prevent new episodes of bacteriuria in elderly women with recurrent UTI as effectively as did NM therapy
Barbosa-Cesnik, et al.[15]	Recurrence of UTI after starting of study/6 months after	6 months	19.3% for cranberry group; 14.6% placebo; P=0.21	Not statedGastrointestinal symptoms were reported twice as frequently for those receiving placebo than cranberry, with the differences statistically significant in months three and five	75.6% for cranberry group; 76.6% in placebo group	Those drinking 8oz of 27% cranberry juice twice daily did not experience a decrease in the 6-month incidence of a second UTI, compared with those drinking a placebo
Ruxer et al.[25]	Complete resolution of dysuric symptoms and eradication of the uropathogen in the follow-up urine bacteriology	6 months	96% in fosfomycin group; 92% in nitrofurantoin group	No clinically relevant adverse reactions or significant laboratory abnormalities reported in fosfomycin groupOne reported after 6-month follow-up with vertigo, most likely related to study drug	96% in fosfomycin group; 88% in NF group	Nitrofurantoin and fosfomycin are effective chemotherapeutic agents both in the treatment and prevention of recurrent UTIs in type 2 diabetic women. Long-term use of fosfomycin and nitrofurantoin is associated with a low risk of adverse drug reactions

UTIs=Urinary tract infections, NM=Nitrofurantoin macrocrystal, TMP-SMX=Trimethoprim-sulfamethoxazole, rUTIs=Recurrent urinary tract infections, GP=General practitoner, NF=Nitrofurantoin