Introduction. The importance of recurrent lower urinary tract infection (LUTI) is associated with its high frequency, a significant decrease in the quality of life and insufficient efficiency of currently available treatment methods. Due to the high antibiotic resistance of uropathogens, the role of alternative therapeutic strategies increases, including substances with antiadhesive properties.
Aim: to evaluate the efficiency of a biologically active additive (BAA) «Ecocystin» containing D-mannose and inulin for the prevention of recurrent LUTI in women.
Materials and methods. A total of 74 women aged 21 to 75 years (mean 47.4±13.6 years) with recurrent LUTI were included in the study. After the initial treatment of LUTI all the patients were divided into two groups. Patients of the main group (n=44) received BAA «Ecocystin», containing D-mannose with antiadhesive properties and inulin, which is a prebiotic, to prevent recurrence of LUTI. Ecocystin was prescribed 1 sachet packet 2 times a day for the first 3 days, and then 1 sachet packet 1 time a day for 6 months. The Ecocystin sachet contains 1.5 g of D-mannose and 1.5 g of inulin. In the control group (n=30) were not prescribed Ecocystin. Clinical indicators were assessed on the 3rd day, as well as after 3 and 6 months from the beginning of the study.
Results. During the first 3 months, recurrent LUTI were diagnosed in 51.7% of patients in the control group and only in 15.9% of patients in the main group (p=0.002). By the 6th month of follow-up, relapses were seen in 75.9% and 29.5% of patients, respectively (p<0.001). In the main group a significant increase in the time interval before the onset of recurrence was found. During the first three months of follow-up, the recurrence of LUTI in the main group developed on average after 43.4±14.3 days compared to 28.2±13.5 days in the control group (p=0.026). In addition, severity and duration of recurrent LUTI in patients of the main group were less pronounced than in the control group.
Conclusion. Our results showed that Ecocystin is an effective drug for the prevention of recurrences in patients with recurrent LUTI. Considering antiadhesive properties of D-mannose, which is part of Ecocystin, this drug can be recommended as a pathogenetically justified alternative to the antibacterial drugs.

Keywords: antiadhesive strategy, inulin, D-mannose, Escherichia coli, acute cystitis, lower urinary tract infections, recurrent cystitis