Konesan Jenane, Liu Lu, Mansfield Kylie J
School of Biomedical Sciences, UNSW, Sydney, NSW 2052, Australia.
Graduate School of Medicine, University of Wollongong, 2522 Wollongong, Sydney, NSW 2052, Australia.
Pathogens. 2022 Dec 5;11(12):1471. doi: 10.3390/pathogens11121471.
The use of antibiotics in the treatment of UTIs is contributing to resistance. Hence, the outcome of human clinical trials of nonantibiotic remedies for preventing or treating UTI is of significant interest. This systematic review aimed to identify, summarise and evaluate the evidence for the outcomes of different nonantibiotic options including cranberry, D-mannose and non-steroidal anti-inflammatory drugs (NSAIDs). PubMed, Embase and Scopus were searched for manuscripts relating to nonantibiotic treatment of UTI including cranberry, mannose and NSAIDs. After title and abstract screening, data were extracted from 21 papers that were published in English and related to the treatment or prevention of uncomplicated UTI in adult women. We identified twelve papers examining the effects of cranberry, two papers examining D-mannose, two papers examining combination treatments (cranberry and D-mannose) and five manuscripts investigating the effects of NSAIDs. There is low-level evidence, from a small number of studies, supporting the use of D-mannose or combination treatments for potentially preventing UTIs in adult women without producing burdening side effects. However, larger and more randomised double-blinded trials are needed to confirm this. In comparison, the multiple studies of cranberry and NSAIDs produced conflicting evidence regarding their effectiveness.
使用抗生素治疗尿路感染正在导致耐药性。因此，非抗生素疗法预防或治疗尿路感染的人体临床试验结果备受关注。本系统评价旨在识别、总结和评估不同非抗生素选择（包括蔓越莓、D-甘露糖和非甾体抗炎药）的疗效证据。在PubMed、Embase和Scopus数据库中检索了与包括蔓越莓、甘露糖和非甾体抗炎药在内的非抗生素治疗尿路感染相关的手稿。经过标题和摘要筛选，从21篇以英文发表的、与成年女性单纯性尿路感染治疗或预防相关的论文中提取数据。我们确定了12篇研究蔓越莓效果的论文、2篇研究D-甘露糖的论文、2篇研究联合治疗（蔓越莓和D-甘露糖）的论文以及5篇研究非甾体抗炎药效果的手稿。少数研究提供的低水平证据支持使用D-甘露糖或联合治疗来潜在预防成年女性的尿路感染，且不会产生严重副作用。然而，需要更大规模和更多随机双盲试验来证实这一点。相比之下，关于蔓越莓和非甾体抗炎药有效性的多项研究得出了相互矛盾的证据。
