The aim of this review is to address clinical reliability, efficacy and safety of long-term treatment with oral D Mannose for the prevention of recurrent urinary tract infections (RUTIs) in females.

A comprehensive systematic MEDLINE, Embase, Cochrane search was performed for English language reports published before December 2018 using the term "recurrent urinary tract infections and d mannose." We searched Medline, Embase, and the Cochrane Register of Controlled Trials since January 2010 to December 2018. Eligible studies did not include non-oral therapy, local (vaginal) treatment in women with RUTIs.

Study eligibility criteria- We identified eligible original articles. The heterogeneity of the available studies, their different rationale and aim, the assumption of d mannose for prophylaxis or treatment of recurrent UTIs need to be taken into account.

Inclusion Criteria:

recurrent urinary tract infections (RUTIs)

Exclusion Criteria:

Upper urinary tract infections, severe clinical symptoms, fever > 37,5 with lumbar pain

Search strategy and selection criteria Only publications with the text and/or the abstract written in the English language were considered. Additional papers cited in the references of the search manuscripts were further examined. Articles not addressing topics of interest were excluded, and the full text of the remaining articles was examined. Our literature search identified 15 articles pertaining to the search terms (Word variations have been searched). Further analysis of these articles resulted in 11 clinical trials which were deemed relevant to our review. The retrieved studies were assessed for their relevance based on the title and abstracts. Finally, studies references were screened in order to identify eventually unknown studies.