Five-Day Nitrofurantoin Beats Single-Dose Fosfomycin for UTI

Increased likelihood of clinical and microbiological resolution for uncomplicated UTI in women
Increased likelihood of clinical and microbiological resolution for uncomplicated UTI in women

HealthDay News — 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, MD, 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% of patients completed the trial.

The researchers found that 70 and 58% of patients receiving nitrofurantoin and fosfomycin, respectively, achieved clinical resolution through day 28 (difference, 12%). Overall, 74 and 63%, respectively, had microbiologic resolution (difference, 11%). 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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