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. 2022 Aug 30;2022(8):CD013608. doi: 10.1002/14651858.CD013608.pub2

Summary of findings 2. D‐mannose (2 g) versus nitrofurantoin (50 mg) for preventing or treating urinary tract infections.

D‐mannose (2 g) versus nitrofurantoin (50 mg) for preventing or treating urinary tract infections
Patient or population: women with acute cystitis or history of recurrent acute cystitis (preventing and treating)
Settings: general hospital and general practice
Intervention: D‐mannose (2 g)
Comparison: nitrofurantoin (50 mg)
Outcomes Illustrative comparative risks* (95% CI) Relative effect
(95% CI) No. of participants
(RCTs) Quality of the evidence
(GRADE)
Assumed risk Corresponding risk
nitrofurantoin
(50 mg) D‐mannose
(2 g)
Symptomatic and bacteriuria‐confirmed UTI (positive culture)
Follow‐up at 24 weeks
204 per 1000 145 per 1000 RR 0.71
(0.39 to 1.31)
206 (1) ⊕⊝⊝⊝
very low1
Symptomatic only UTI No data No data No data No data ‐‐
Asymptomatic bacteriuria No data No data No data No data ‐‐
Changes to previous treatment regimen No data No data No data No data ‐‐
Pain No data No data No data No data ‐‐
Cure/complete remission No data No data No data No data ‐‐
Adverse effects
Follow‐up at 24 weeks
282 per 1000 79 per 1000
(37 to 160)
RR 0.28
(0.13 to 0.57)
206 (1) ⊕⊝⊝⊝
very low1
*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; RR: Risk Ratio; UTI: urinary tract infection
GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1Downgraded for very serious limitations in the study design or execution (high risk of bias) (‐2), and sparse data (single study data) (‐1).