Comparison of Fosfomysin Trometamol and Ciprofloxacin in Uncomplicated Urinary Tract Infections

Abstract

INTRODUCTION
Acute urinary tract infection (UTI) is one of the most common infections requiring empirical antibiotic therapy. Selection of efficient and safe antimicrobial agent is important in the emergency department (ED).
The aim of this study is to compare the microbiological and clinical efficiency of single–dose fosfomycin trometamol (FT) therapy with a 3-day course of ciprofloxacin (CP) for uncomplicated UTI.
METHODS
This randomized, prospective, single-blind study evaluated women aged 18-65 years complaining of dysuria, frequency and urgency whose onset of symptoms were within 72 hours of enrollment, in the ED. Patients received either a single-dose FT or 3-day course of CP. Patients with positive cultures of mid-stream urine samples constituted study patients. Microbiological and clinical cure were assessed at the test-of-cure visit (7-10 days after completion of therapy). Chi-square tests were used to compare efficiencies of regimens.
RESULTS
Mean age of 81 women in the study was 30±12. There were 40 patients in the FT group and 41 patients in the CP group. The most common uropathogen isolated was E. Coli in 50 samples (61.3%).
Clinical cure was demonstrated in 38 patients (96%) of the FT group and 38 patients (93%) of the CP group (χ²: 0,347, df: 1, P=0,275). Bacteriologic eradication was achieved in 30 patients (80%) of the FT treated group and 27 patients (65,8%) of the CP treated group (χ²: 0,1591, df: 1, P=0,207). 3 patients (7.5%) in FT and 4 patients (10 %) in the CP group experienced pyrosis, while nausea was seen in 5 patients (12%) in the CP group as adverse events.
CONCLUSION
In the current study fosfomycin trometamol therapy was safe and effective as ciprofloxacin in the first treatment of acute uncomplicated UTI.