Ask the Pharmacist Question:
I have frequent UTIs and have been thoroughly examined and tested by a urologist. No matter what, I just keep getting them.
I am currently on some heart meds and blood thinners for AFib but am not on any meds for my CLL. Someone suggested D Mannose for the UTIs. Is it safe? Do you know if it is effective?
Answer: There is no good scientific evidence to support the use of D Mannose for UTIs.
However, in reading your question a couple of other bigger things come to mind that are more related to your CLL diagnosis. There might be a concern related more to your CLL causing the repetitive infections versus focusing on just treating the UTIs. In CLL, gradually over long periods of time the immunoglobulin levels in the blood will fall. As they fall, there is an increased risk of infection. Infections are one of THE most significant problems for those with CLL and can be reason for concern, especially when they are repetitive.
Without knowing your exact medical history and lab results, it is impossible to provide guidance. But we would suggest the following:
- Make sure you are seeing a CLL expert and have you made them aware of your recurrent bacterial infections (not just a primary doc or urologist). They need to know if you have repetitive infections of ANY kind. This is because there needs to be further investigation immediately into your CLL lab work.
- Have you had your immunoglobulin/antibody levels tested recently to see if you have an antibody deficiency (IgG/IgA, etc.)? You can read more about the importance of this here as it relates to infection in CLL: https://cllsociety.org/2016/12/immunogobulins-and-ivig/
It is a relatively common finding to have antibody deficiency in CLL. The incidence seems to increase with disease duration and is present in up to 85% of patients at some point in the course of their disease. Published guidelines suggest that patients with a history of recurrent bacterial infections combined with a documented failure of antibody production are the ones who should be treated first with antibiotic prophylaxis (daily doses long term, not just for a few days). Then replacement immunoglobulin therapy should be considered for those who suffer with recurring or persistent infections.