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Five-Day Nitrofurantoin Beats Single-Dose Fosfomycin for UTI

TUESDAY, April 24, 2018 -- Five-day nitrofurantoin is associated with increased likelihood of clinical and microbiological resolution compared with single-dose fosfomycin among women with lower urinary tract infection (UTI), according to a study published online April 22 in the Journal of the American Medical Association.

Angela Huttner, M.D., from Geneva University, and colleagues conducted a randomized clinical trial involving 513 non-pregnant women with symptoms of lower UTI, a positive urine dipstick result, and no known colonization or previous infection with uropathogens resistant to the study antibiotics. Participants were randomized to oral nitrofurantoin for five days (255 patients) or a single dose of oral fosfomycin (258 patients); 93 percent of patients completed the trial.

The researchers found that 70 and 58 percent of patients receiving nitrofurantoin and fosfomycin, respectively, achieved clinical resolution through day 28 (difference, 12 percent). Overall, 74 and 63 percent, respectively, had microbiologic resolution (difference, 11 percent). There were few adverse events and they were mainly gastrointestinal, most commonly nausea and diarrhea.

"Among women with uncomplicated UTI, five-day nitrofurantoin, compared with single-dose fosfomycin, resulted in a significantly greater likelihood of clinical and microbiologic resolution at 28 days after therapy completion," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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Posted: April 2018

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