Adding collagen, propolis plus quercetin, bacillus coagulans, hyaluronic acid and chondroitin sulphate to D-mannose avoids symptoms and prevents recurrence in women with recurrent urinary tract infections: a single-blind randomized controlled trial.
Gaetano Riemma, Davide Vinci, Marco La Verde, Florindo Mario Caniglia, Gaetano Scalzone, Marco Torella
Author Information
Gaetano Riemma: Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy. ORCID
Davide Vinci: Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Marco La Verde: Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Florindo Mario Caniglia: Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Gaetano Scalzone: Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Marco Torella: Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
BACKGROUND: To evaluate the efficacy of a new D-mannose dietary supplement containing D-mannose, Propolis-Quercetin, Bacillus Coagulans, Hyaluronic Acid and Chondroitin Sulfate with fosfomycin in reducing rUTI episodes and improving quality of life. RESEARCH DESIGN AND METHODS: Single-blind, randomized controlled trial conducted at tertiary-care hospital in Italy. Women aged 21-65 with a history of rUTIs were randomized into three groups: fosfomycin, the dietary supplement, and a combination of both treatments. Primary outcome was frequency of rUTI episodes per month. RESULTS: Combination therapy demonstrated greatest reduction in rUTI episodes per month at 12���months compared to fosfomycin or supplement monotherapy (0.23��������0.37 vs 0.58��������0.67 and 1.12��������0.96 for fosfomycin and supplement monotherapy respectively; ���<���0.05) and to supplement monotherapy at 6���months (0.69��������1.03 vs 1.43��������1.33; ���<���0.05), with significant improvement of ICIQ-FLUTS domains compared to other groups at 12���months (���<���0.05). Combination therapy had lower number of women matching rUTI criteria (55.32% vs 76.47% and 84%; ���<���0.05) and symptoms remission at 12���months (89.36% vs 56.86% and 20%; ���<���0.001). CONCLUSIONS: 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. TRIAL REGISTRATION: The trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT06659016).
