Titre du document / Document title

Comparison of single-dose fosfomycin and a 7-day course of nitrofurantoin in female patients with uncomplicated urinary tract infection

Auteur(s) / Author(s)

STEIN G. E. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Medicine, Michigan State University, East Lansing, Michigan, ETATS-UNIS

Résumé / Abstract

This multicenter clinical trial compared single-dose fosfomycin tromethamine with a 7-day course of nitrofurantoin for the treatment of acute uncomplicated lower urinary tract infection (UTI) in female patients. Healthy females with symptoms of acute uncomplicated UTI were enrolled in a double-masked, randomized clinical trial. Assessable patients had ≥10⁵ colony-forming units per milliliter of a uropathogen in a clean-voided midstream urine sample. Patients received a single 3-g dose of fosfomycin tromethamine plus 7 days of placebo capsules or a single 3-g dose of placebo plus 7 days of nitrofurantoin monohydrate/macro-crystal 100-mg capsules. Treatment efficacy was assessed by both bacteriologic and clinical response 5 to 11 days after the initial treatment dose (visit 2) and 5 to 1 1 days (visit 3) and 4 to 6 weeks (visit 4) after the last day of medication. Of the 749 patients initially enrolled in the study, 375 received fosfomycin and 374 received nitrofurantoin. There were no clinical differences in patient characteristics between the 2 groups at study entry. Overall, 94% of pretreatment isolates were susceptible to fosfomycin and 83% were susceptible to nitrofurantoin. Bacteriologic cure rates at the first follow-up visit (5 to 11 days after initiation of treatment) were 78% and 86% for fosfomycin and nitrofurantoin, respectively (P = 0.02). At visit 3 (1 week posttreatment), they were 87% and 81% for fosfomycin and nitrofurantoin, respectively (P = 0.17). Both treatment groups had an 80% overall clinical success rate (cure and improvement). Twenty patients (5.3%) who received fosfomycin and 21 patients (5.6%) who received nitrofurantoin reported an adverse effect related to study medication. The most common side effects related to fosfomycin treatment were diarrhea (2.4%), vaginitis (1.8%), and nausea (0.8%). Both bacteriologic and clinical cure rates observed with a single 3-g dose of fosfomycin were comparable to those achieved with a 7-day course of nitrofurantoin in female patients with acute uncomplicated UTI.

Revue / Journal Title

Clinical therapeutics   ISSN 0149-2918 

Source / Source

1999, vol. 21, n^o11, pp. 1864-1872 (19 ref.)

Langue / Language

Anglais

Editeur / Publisher

Excerpta Medica, Belle Mead, NJ, ETATS-UNIS  (1977) (Revue)

Mots-clés anglais / English Keywords

Cystitis ; Infection ; Fosfomycin ; Single dose ; Nitrofurantoin ; Multiple dose ; Comparative study ; Chemotherapy ; Treatment ; Human ; Female ; Antibiotic ; Antibacterial agent ; Furan derivatives ; Nitro compound ; Urinary system disease ; Bladder disease ; Urinary tract disease ;

Mots-clés français / French Keywords

Cystite ; Infection ; Fosfomycine ; Dose unique ; Nitrofurantoïne ; Dose répétée ; Etude comparative ; Chimiothérapie ; Traitement ; Homme ; Femelle ; Antibiotique ; Antibactérien ; Furane dérivé ; Composé nitro ; Phosphonique acide dérivé ; Appareil urinaire pathologie ; Vessie pathologie ; Voie urinaire pathologie ;

Mots-clés espagnols / Spanish Keywords

Cistitis ; Infección ; Fosfomicina ; Dosis única ; Nitrofurantoína ; Dosis múltiple ; Estudio comparativo ; Quimioterapia ; Tratamiento ; Hombre ; Hembra ; Antibiótico ; Antibacteriano ; Furano derivado ; Compuesto nitro ; Aparato urinario patología ; Vejiga patología ; Vía urinaria patología ;

Localisation / Location

INIST-CNRS, Cote INIST : 18353, 35400008089493.0040