Please select the eligibility criteria that correspond to the clinical trial below.
Title: Recurrent Urinary Tract Infections in Adult Women: a Pilot Study With Oral D Mannose
Brief Summary: Background- In recurrent urinary tract infections (RUTIs) usual prophylactic antibiotic regimes do not change the long term risk of recurrence.

Objective- D-Mannose is a sugar, it sticks to E. coli bacteria, the aim of the study was to evaluate its efficacy in the treatment and prophylaxis of recurrent UTIs.

Design, setting and participants- : In this crossover trial female patient were eligible for the study if they had recurrent UTIs, that is three ore more episodes during the preceding 12 months. Suitable patients were randomly assigned to antibiotic treatment with trimethoprim/sulfamethoxazole or to a regimen of oral D Mannose for 24 weeks, and received the other intervention in the second phase of the study.

Outcome measurements and statistical analysis- The time to recurrence of UTI, bladder pain (VAS p) and urinary urgency (VAS u) were evaluated at the end of antibiotic therapy and at the and of 24 weeks fo D Mannose. The results for quantitative variables were expressed as mean values and SD as they were all normally distributed (Shapiro-Wilk test). T-test for paired data was used to analyze differences of time of recurrence, VAS pain, Vas urgency and number of voidings between treatment. Data analysis was performed with STATA statistical package (release 11,1, 2010, Stata Corporation, College Station, Texas, USA).


Options:
A: Inclusion Criteria:

* Postmenopausal women
* History of recurrent UTI (\>=3 culture proven UTIs in one year or \>=2 in 6 months)
* Recurrent, culture proven UTI while on vaginal estrogen for at least 4 weeks + d-mannose prophylaxis
* English speaker

Exclusion Criteria:

* Not postmenopausal
* Complicated UTIs
* Known renal tract anomaly
* Liver dysfunction
* Neurogenic bladder
* Incomplete bladder emptying (PVR \> 150 cc when voided volume \>150 cc)
* Self-catheterization or use of indwelling catheter
* Contraindication to vaginal estrogen, methenamine hippurate, or d-mannose, including allergic reactions
* History of or current endometrial cancer
* History of estrogen sensitive breast cancer without approval of patient, patient's oncologist, oncologic surgeon, or primary care physician to use vaginal estrogen after counseling
* History of interstitial cystitis/painful bladder syndrome
* Urothelial cancer
* Enrolled in other clinical trials for UTIs other than Washington University study IRB# 201711120
* Currently on daily antibiotic prophylaxis and unwilling to stop this intervention
B: Inclusion Criteria:

* Patients 18 years old or older
* 3 or more culture documented urinary tract infections in the preceding 12 months
* Patients who had not taken antimicrobials within 4 weeks and were not pregnant or contemplating pregnancy.

Exclusion Criteria:

* Patients with evidence of upper urinary tract infection, such as temperature higher than 38 °C, flank/lumbar pain or tenderness.
C: Inclusion Criteria:

* Women
* ≥ 3 UTIs within the last 12 months or ≥ 2 UTIs within the last 6 months;
* Laboratory urine culture: \<103 CFUs
* Age \> 18 years

Exclusion Criteria:

* UTIs ≥ 12 within 1 year
* Pregnancy or Lactation
* Immune disease
* Lactose intolerance
* Urinary tract anomaly
* Systemic infection
* Newly started hormone therapy within the last 6 months
* Antibiotic prophylaxis within the last 6 months
* α-D-mannose intake within the last month
* Use of catheters
* Diabetes mellitus
* Participation to other studies
D: Inclusion Criteria:

* Presenting with symptoms of UTI
* Presentation of 3rd or 4th simple cystitis of lower tract in the past 12 months
* Active infection at enrollment, confirmed and documented in medical record
* Cognitive capacity to consent and ability to undergo the consent process in English

Exclusion Criteria:

* Known allergy or intolerance to supplement ingredients
* Pregnant or planning to become pregnant or lactating
* Unwilling to commit to birth control use
* Use of related nutritional supplements
* Unwilling to halt berry extracts, polyphenols, antioxidants, d-mannose, vitamins
* Taken WelTract in past six months
* Unwilling to avoid probiotics, yogurt, apple or cranberry juice, hibiscus tea
* Certain comorbid or physical conditions
* History of febrile UTI
* Bladder catheter or urethral stents
* Use of topical hormones in urogenital areas
* Diabetes (i.e. taking diabetic medications) or glycosuria
* Intestinal diseases with malabsorption (e.g. Crohn's and celiac diseases)
* Severe renal impairment or kidney stones
* Neural problems (spinal cord injury or Multiple Sclerosis)
* Immunocompromised individuals
* Rheumatoid arthritis
* Lupus
* HIV
* Taking steroids or immunobiologic medications
* Prophylactic antibiotic use (e.g. post-coital)
* Other physician judgement

Answer: B