Is single-dose fosfomycin trometamol a good alternative for asymptomatic bacteriuria in the second trimesterof pregnancy?

Department of Obstetrics and Gynecology, Fatih University, İstanbul, Istanbul, Turkey
International Urogynecology Journal (Impact Factor: 2.16). 06/2007; 18(5):525-9. DOI: 10.1007/s00192-006-0190-y
Source: PubMed

ABSTRACT Untreated asymptomatic bacteriuria has been associated with acute pyelonephritis, which may have a role in many maternal and fetal complications. Acute pyelonephritis in pregnancy is related to anemia, septicemia, transient renal dysfunction, and pulmonary insufficiency. A randomized study was conducted to assess the clinical and microbiological efficacy of a single dose of fosfomycin trometamol for the treatment of asymptomatic bacteriuria in the second trimester of pregnancy compared with a 5-day regimen of cefuroxime axetyl. Forty-four women received fosfomycin trometamol and 40 women received cefuroxime axetyl. There were no statistically significant differences between both groups regarding the mean age and mean duration of pregnancy. Therapeutic success was achieved in 93.2% of the patients treated with fosfomycin trometamol vs 95% of those treated with cefuroxime axetyl. A single dose of fosfomycin trometamol is a safe and effective alternative in the treatment of asymptomatic urinary tract infections in the second trimester of pregnancy.

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    ABSTRACT: Fosfomycin trometamol (fosfomycin tromethamine) [Monuril(®), Monurol(®), Monural(®)] is approved in numerous countries worldwide, mainly for the treatment of uncomplicated urinary tract infections (UTIs). Fosfomycin has good in vitro activity against common uropathogens, such as Escherichia coli (including extended-spectrum β-lactamase-producing E. coli), Proteus mirabilis, Klebsiella pneumoniae and Staphylococcus saprophyticus, and the susceptibility of uropathogens to fosfomycin has remained relatively stable over time. A single oral dose of fosfomycin trometamol 3 g (the approved dosage) achieves high concentrations in urine. Results of recent randomized trials indicate that single-dose fosfomycin trometamol had similar clinical and/or bacteriological efficacy to 3- to 7-day regimens of ciprofloxacin, norfloxacin, cotrimoxazole or nitrofurantoin in women with uncomplicated lower UTIs. In addition, single-dose fosfomycin trometamol had similar bacteriological efficacy to a 5-day course of cefuroxime axetil or a 7-day course of amoxicillin/clavulanic acid in pregnant women with asymptomatic bacteriuria, and similar clinical and/or bacteriological efficacy to a 5-day course of cefuroxime axetil or amoxicillin/clavulanic acid or a 3-day course of ceftibuten in pregnant women with a lower UTI. Single-dose fosfomycin trometamol was generally well tolerated, with gastrointestinal adverse events (e.g. diarrhoea, nausea) reported most commonly. In conclusion, single-dose fosfomycin trometamol is an important option for the first-line empirical treatment of uncomplicated lower UTIs.
    Drugs 11/2013; DOI:10.1007/s40265-013-0143-y · 4.13 Impact Factor
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    ABSTRACT: Title: Epidemiological analysis of urinary tract infections and exposure to Fosfomycin during pregnancy in mothers of infants with and without congenital defects: Distribution by years and Autonomous Regions. The objective of this study was to epidemiologically analyze urinary tract infections (UTI) suffered by pregnant women, and the prenatal exposure to Fosfomycin. To accomplish this objective, data from the Spanish Collaborative Study of Congenital Malformations (ECEMC) were analyzed for the period 1978-2009. A total of 40,060 newborn infants with congenital defects, and a similar number of healthy controls were registered. The proportions of mothers of cases and controls who suffered UTI during the first trimester were 2.69% and 2.56%, respectively. These figures go up to 9.94% and 8.86% when considering UTI at any time during pregnancy. The proportions of mothers who were treated with fosfomycin during the first trimester of pregnancy were 0.67% and 0.69%, respectively for cases and controls, and those figures go up to 2.69% y 2.54% when considering exposures at any time during pregnancy. Use of fosfomycin at any time during pregnancy has progressively increased with time. When studying the geographical distribution of the frequency some differences regarding UTI and use of fosfomycin were detected. The increase in use of fosfomycin has caused a decrease of the use of other antibiotics, and these trends are also observed in several autonomous regions in Spain. The use of fosfomycin during pregnancy seems to be safe, and suffering an UTI is quite common during pregnancy and somehow dangerous for the progress of gestation. It is important to underline that the percentage of mothers without treatment was between 20 and 35%. Therefore, it is advisable to treat UTI as soon as possible, in order to avoid complications both for the mother and fetus.
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    ABSTRACT: Introduction: The efficacy and tolerability of fosfomycin in a single dose of 3 g was compared with ciprofloxasin 500 mg for three days in the treatment of adult female patient with uncomplicated urinary infections. Materials and Methods: 100 female patients with a mean age of 36.2±4.53 years who presented symptoms of dysuria and frequency with documented pyuria and bacteriuria on urinalysis (>100.000 cfu/ml of urine) were initially included in the study. The total number of clinically and bacteriologically evaluable patient was 100, of which 50 received fosfomycin trometamol and 50 ciprofloxacin. Results: One to two days after the double blind medication schedule for seven days 48 of 50 patients (96%) in the fosfomycin trometamol group and 47 of 50 patients (94%) in the ciprofloxacin group were clinically cured. No side effect was seen in fosfomycin group but gastrointestinal side effect was seen in 3 patients in ciprofloxacin group. Conclusion: Single dose fosfomycin in treatment of uncomplicated urinary infection in women shows that similar efficacy and more tolerability than does three days ciprofloxacin treatment.

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