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

Document Type : Original Article

Authors

1 Obstetrics and Gynecology Department, Shebin El-Kom Teaching Hospital, Menoufia, Egypt.

2 Obstetrics 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.
 

Keywords

The Egyptian Journal of Hospital Medicine
Volume 82, Issue 4
January 2021
Pages 626-631

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