El-Mehy, S., Sanad, Z., El-Lakwa, H. (2021). Efficacy and Safety of Fosfomycin Single-Dose Therapy Compared to Nitrofurantoin and Cephalosporin in Pregnant Women with Lower Urinary Tract Infection: A Randomized Controlled Trial. The Egyptian Journal of Hospital Medicine, 82(4), 626-631. doi: 10.12816/ejhm.2021.150416
Sherif Ramadan El-Mehy; Zakria Fouad Sanad; Hamed El-Sayed El-Lakwa. "Efficacy and Safety of Fosfomycin Single-Dose Therapy Compared to Nitrofurantoin and Cephalosporin in Pregnant Women with Lower Urinary Tract Infection: A Randomized Controlled Trial". The Egyptian Journal of Hospital Medicine, 82, 4, 2021, 626-631. doi: 10.12816/ejhm.2021.150416
El-Mehy, S., Sanad, Z., El-Lakwa, H. (2021). 'Efficacy and Safety of Fosfomycin Single-Dose Therapy Compared to Nitrofurantoin and Cephalosporin in Pregnant Women with Lower Urinary Tract Infection: A Randomized Controlled Trial', The Egyptian Journal of Hospital Medicine, 82(4), pp. 626-631. doi: 10.12816/ejhm.2021.150416
El-Mehy, S., Sanad, Z., El-Lakwa, H. Efficacy and Safety of Fosfomycin Single-Dose Therapy Compared to Nitrofurantoin and Cephalosporin in Pregnant Women with Lower Urinary Tract Infection: A Randomized Controlled Trial. The Egyptian Journal of Hospital Medicine, 2021; 82(4): 626-631. doi: 10.12816/ejhm.2021.150416
Efficacy and Safety of Fosfomycin Single-Dose Therapy Compared to Nitrofurantoin and Cephalosporin in Pregnant Women with Lower Urinary Tract Infection: A Randomized Controlled Trial
1Obstetrics and Gynecology Department, Shebin El-Kom Teaching Hospital, Menoufia, Egypt.
2Obstetrics and Gynecology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
Abstract
Background: Fosfomycin is a bactericidal drug that inhibits bacterial cell wall and also reduces the adherence ability of bacteria to uro-epithelial cells with a broad anti-bacterial activity against both Gram-negative and Gram-positive. Objective: To compare the efficacy and safety of fosfomycin compared to nitrofurantoin and cephalosporin in pregnant women presented with lower urinary tract infection. Patients and Methods: This was a double blinded, randomized controlled trial conducted at Shebin El-Kom Teaching Hospital from Aug 2019 to Aug 2020. Patients experienced uncomplicated lower urinary tract infection either asymptomatic bacteriuria or cystitis were recruited. Patients were randomly allocated via a random table number into three groups, each group comprised 35 patients. Group I received 3 g oral fosfomycin weekly, group II received 100 mg oral nitrofurantoin three times daily, and group III received 500 mg oral cephalosporin three times daily. After 7 days of treatment, all studied groups were subjected to urine sampling and culture analysis and were examined for occurrence of side effects. Results: All patients enrolled in our study had uncomplicated lower urinary tract infection either cystitis (n=85 cases) or asymptomatic bacteriuria (n=20 cases). There was clinical difference in urine pus cells and urine culture in fosfomycin after treatment compared to other groups. The side effects were reported in 7 cases with fosfomycin compared to 14 in other two groups with significant difference. Conclusion: Fosfomycin tromethamine was proved to be more effective, safe, and fewer side effects were reported, which makes fosfomycin the drug of choice for uncomplicated lower urinary tract infection during pregnancy.
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