d-mannose for prophylaxis against Urinary tract Infection in Spinal Cord Injury

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Scientific studies have shown that urinary tract infection (UTI) occurs in 40 to 50% of people who sustain a spinal cord injury. Our local audit confirms a similar percentage at the Auckland Spinal Rehabilitation Unit (ASRU) with almost half of all our patients experiencing at least one episode of UTI following spinal cord injury. Our regular practice to reduce the risk of urinary tract infection is to increase fluid intake, provide appropriate care of the catheter system, ensure good hygiene with catheter use and, when possible, discontinue the indwelling catheter or discontinue and commence an intermittent catheterization program as soon as possible. Infections are treated with increasing water consumption and appropriate antibiotics after checking a urine culture. We would like to know if d mannose reduces risk of UTI in people with spinal cord injury/impairment (SCI). D mannose, which is registered as a health supplement product in NZ, has been shown to reduce the risk of urinary tract infection (UTI) in women. D mannose is a natural sugar, which binds with bacteria and prevents adhesion of the bacteria to the bladder wall thus, presumably, reducing infection in the bladder. No studies have been done to determine D mannose’s effectiveness in prevention of UTI in the spinal cord injury population. To test the effectiveness of d mannose in reducing UTI in SCI, we have developed a pilot randomised control trial (RCT) at ASRU and Middlemore Hospital (MMH).

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