Single-Dose Fosfomycin Trometamol Versus Other Antimicrobial Regimens For Treatment Of Uncomplicated Lower Urinary Tract Infection: A Systematic Review And Meta-Analysis

Abstract

Objectives: Uncomplicated Lower Urinary Tract Infections (LUTIs) are the most common source of infection affecting women. The increasing prevalence of antimicrobial resistance to commonly prescribed antibiotics has led to the development and use of novel therapies. This current meta-analysis and systematic review evaluate the use of single-dose Fosfomycin-Trometamol (FMT) versus alternative antimicrobial regimens in the management of uncomplicated LUTI. Methods: This is a systematic review. We included observational studies and Randomized Controlled Trials (RCTs). Studies that investigated the efficacy of fosfomycin or FMT in managing uncomplicated LUTIs in any age group or gender and compared the treatment to any alternative antibiotic regimen were considered eligible. Results: After a comprehensive review of the literature, nineteen studies fulfilled the inclusion criteria. All of the eligible studies (3779 patients) investigated showed no difference between the use of single-dose fosfomycin versus alternative antibiotic regimens for LUTI treatment (OR, 1.003; 95% CI, 0.853-1.181; p = 0.967). The OR remained unchanged but became statistically significant when the random-effects model was used for sensitivity analysis (OR, 1.53; 95% CI, 1.05-2.38; p = 0.04). Conclusion: The meta-analysis revealed that there was no significant difference between single-dose FMT and the commonly prescribed antibiotic regimens in LUTI treatment outcomes such as clinical improvement and microbial eradication.

Why D-Mannose May Be as Efficient as Antibiotics in the Treatment of Acute Uncomplicated Lower Urinary Tract Infections Preliminary Considerations and Conclusions from a Non-interventional Study

“…The clinical success rates were 77.9% (95% CI 75.4-80.3%) for fosfomycin and 79.0% (95% CI 75.0-82.6%) for nitrofurantoin. The averaged clinical cure rate for the other antibiotics was 84.6% (95% CI 81.2-0.87.6%) [46]. These results showed no clinically significant differences between the microbiological and clinical cure rates and gave comparable results between the different antibiotic groups.…”

“…As the clinical cure or improvement of AUC symptoms during and following treatment becomes increasingly focused on treatment efficacy, the clinical success rate should be evaluated primarily in clinical trials. A systematic review of 19 studies including 3,779 patients in total compared the clinical and microbiological efficacy of single-dose fosfomycin with other antibiotic regimens [46]. The microbiological cure rate was 78.9% (95% CI 76.2-81.4%) for fosfomycin and 77.1% (95% CI 72.2-81.5%) for nitrofurantoin.…”

The use of oral fosfomycin-trometamol in modern clinical practice

“…В завершение: в недавнем метаанализе 19 РКИ (2 из которых -двойные слепые) срав нивали клиническую и микробиологическую эффективность пероральной терапии неослож ненных ИМП одной дозой фосфомицина тро метамола 3,0 г с лечением альтернативными антибиотиками. В обоих случаях эффектив ность оказалась сопоставимой [3].…”

Infecção do trato urinário em gestantes: avaliação da susceptibilidade dos uropatógenos aos antimicrobianos em uroculturas positivas/Urinary tract infection in pregnant women: assessing uropatogen susceptibility to antimicrobials in positive urocultures

“…A Nitrofurantoína, apesar de demonstrar eficiência sobre uropatógenos, está associada à anemia hemolítica do recém-nascido quando utilizada no último trimestre da gestação (BARBALHO et al 2019;CALIXTO et al, 2019). O Congresso Americano de Obstetras e Ginecologistas (ACOG) apoia o uso da Nitrofurantoína no primeiro trimestre, quando não há a alternativas adequadas disponíveis, sendo a droga de escolha em casos de infecções recorrentes (GLASER; SCHAEFFER, 2015).…”

“…Tanto a Nitrofurantoína (100mg, VO, 6/6 horas) como a Fosfomicina (3 g, VO, dose única) são antimicrobianos largamente utilizados e recomendados em casos de cistite não complicada em gestantes, apresentando altas taxas de cura. Esse bom desempenho deve-se ao fato de que essas drogas apresentam altas taxas de excreção urinária, otimizando sua atuação em casos de ITU e são ativas mesmo contra bactérias multidrogas resistentes (BARBALHO et al 2019;MANDUJANO, 2019).…”