A Comparative Randomized Study of Nitrofurantoin and Fosfomycin in the Treatment of Urinary Tract Infections in Nonpregnant Women at a Tertiary Care Rural Hospital, Karnataka.

Abstract

INTRODUCTION: Urinary tract infections are the most common infections seen in the hospital setting and take the second lead after respiratory tract infection in community acquired infections. Nitrofurantoin and Fosfomycin are older drugs that are being revived and recommended as first-line agents in treating uncomplicated UTI. AIMS AND OBJECTIVES: To assess the comparative efficacy of 5day nitrofurantoin versus single dose fosfomycin for clinical resolution in uncomplicated UTI. MATERIALS AND METHODS: This randomized clinical trial was conducted from January 2019 to September 2019 at the Department of Obstetrics and Gynaecology, AIMS, B G Nagara, Mandya, Karnataka. Patients were randomized to either oral nitrofurantoin 100mg twice daily for 5 days or single dose of oral fosfomycin 3g. Baseline urine routine was done. They were followed up at 14(+/-2) and 28(+/-7) days after completion of antibiotic therapy which was considered at day 5 as fosfomycin has long half-life. The data was entered in Microsoft Excel and outcomes were analysed using Epi Info software. RESULTS: Out of total 92 patients screened,63 were enrolled and randomized. Thirty-two (50.7%) were given nitrofurantoin and 31 (49.2%) received fosfomycin. Of total enrolled after screening 3 (4.7%) patients were lost to follow-up, so only 60 patients (n=92, 65.2%) comprised the study population. CONCLUSION: Five-day nitrofurantoin is superior to single dose fosfomycin in treatment of acute uncomplicated UTI.