Comparison effectiveness of fosfomysin trometamol and ciprofloxacin in treating uncomplicated urinary tract infections

Abstract

Objectives: 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 the treatment of uncomplicated UTI. Methods: This randomized, prospective, single-blind study evaluated women aged between 18 and 65 years and complaining of dysuria, frequency and urgency in the ED. The onset of symptoms were less than 72 hours before admission to the ED. Patients received either a single-dose FT or 3-day course of CP. Those 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 included 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 subjects (61.3%). Clinical cure was demonstrated in 38 patients (96%) in the FT group and 38 patients (93%) in the CP group (χ2: 0,347, df: 1, p=0.275). Bacteriologic eradication was achieved in 30 patients (80%) in the FT treated group and 27 patients (65.8%) in the CP treated group (χ2: 0,1591, df: 1, p=0.207). 3 patients (7.5%) in the 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. Conclusions: Fosfomycin trometamol therapy was found to be as safe and effective as ciprofloxacin as a first line treatment of acute uncomplicated UTI.