Single dose fosfomycin trometamol versus multiple dose norfloxacin over three days for uncomplicated UTI in general practice

Abstract

The aim of this study was to carry out a small-scale bacteriological comparison between a standard therapy with norfloxacin 400 mg twice daily, and fosfomycin trometamol (3 g) in single dose in uncomplicated urinary tract infections (UTI) in women. Only patients with UTI with cultures showing a bacterial count of 10(5) or more bacteria/ml were included in the study (n = 32; ages 16-75 years). After one week sterile cultures were obtained in 14 of 16 cases in the fosfomycin trometamol group, and in 14 of 16 cases in the norfloxacin group. After one month eradication was confirmed in 13 of 16 patients in the fosfomycin trometamol group, and in nine of 16 patients in the norfloxacin group. Recurrence was seen in one case in the fosfomycin trometamol group, and in five cases in the norfloxacin group. The reinfection and persistence rates were identical (1/16) in both groups. The main clinical symptoms disappeared very rapidly after initiating treatment, and the correlation with the bacteriological data after one week was excellent. Both drugs were well tolerated and the compliance for fosfomycin trometamol was 100%.

Adverse events of fluoroquinolones vs. other antimicrobials prescribed in primary care: A systematic review and meta-analysis of randomized controlled trials

“…Nearly 80% of the studies had low attrition and reporting bias. Two of the studies (34,46) were very poorly reported in all of the six domains evaluated. Symmetric funnel plots showed a very small number of studies suffered from publication bias except for those studies included in the meta-analysis of skinrelated AEs ( Supplementary Figure 2: funnel plot).…”

“…A high level of heterogeneity was observed in total AEs, GI-related and skin-related AEs among the included studies. For total AEs, a slight increase in heterogeneity (67% to 72%) and effect estimate (1.07 to 1.14) was observed when studies with a higher risk of bias (20,34,35,39,40,44,46,51,52,56) were excluded. Subgroup analysis by FQ agents did not change heterogeneity.…”

Cost-Effectiveness Analysis of Fosfomycin for Treatment of Uncomplicated Urinary Tract Infections in Ontario

“…In addition to the biological aspect of the low fosfomycin resistance rate, single-dose antibiotics are associated with a high degree of compliance and greater convenience, which may help prevent resistance from developing [19, 51, 52]. Maintenance of 100% adherence to optimized dosing regimens is critical for ensuring antimicrobial efficacy of the drug and prevention of resistance.…”

New Horizons for the Role of Fosfomycin in the Era of Multi-drug Resistant Urinary Tract Infections

“…За час застосування в клінічній практиці проведено близько 60 контрольованих клінічних досліджень застосування пероральної форми фосфоміцину при гострому циститі, а також опубліковано результати метааналізів щодо цієї теми [3,7,13,16,17,19,21,22,. Вживання разової дози 3 г препарату порівнювали з хінолонами і фторхінолонами -норфлоксацином [27,32,33,36,37,42], ципрофлоксацином [41,52], офлоксацином [29], пефлоксацином [53], нітрофуранами [16,25,38,44,54], цефалоспоринами [39,55], амінопеніцилінами [28,48] і аміноглікозидами [26], а також триметопримом [31,43] та поєднанням сульфаметоксазолу/триметоприму (TMP/SMX) [29,30].…”