Comparison of a single use of fosfomycin with 5-day antibiotic cycles in the treatment of lower urinary tract infections in pregnant women

The objective of the study, carried out on the basis of the Department of Obstetrics and Gynecology at one of the hospitals in Istanbul (Turkey), was to compare the effectiveness and determine the differences in compliance during the use of phosphomycin trometamol, cefuroxime axetil and amoxicillin / clavulanate in the treatment of urinary tract infections during pregnancy.

Between September 2007 and May 2008, 90 of the 324 pregnant women with lower urinary tract infections observed on an outpatient basis or referred to hospital emergency services were included in this prospective study. Patients were randomized into 3 identical treatment groups (30 patients in each group): patients in the 1st group received phosphomycin trometamol once, women in the 2nd group received a 5-day course of amoxicillin / clavulanate , patients in the 3rd group received a 5-day course of cefuroxime axetil. At the end of the follow-up period, the data for analysis were obtained for 28, 27 and 29 patients in each group, respectively.

No statistically significant difference was found between treatment groups in the frequency of clinical efficacy of treatment, the frequency of microbiological eradication of the pathogen, and the incidence of adverse events. At the same time, statistically higher compliance was observed with a single dose of trometamol fosfomycin compared to cefuroxime axetil and amoxicillin / clavulanate (p less than 0.05).

Thus, treatment with a single dose of trometamol fosfomycin is as effective and safe as the usual long-term treatments of antimicrobial treatment using cefuroxime axetil or amoxicillin / clavulanate. Fosfomycin trometamol may be the preferred choice for the treatment of patients with UTI due to a simpler regimen and, therefore, better compliance.