SINGLE-DOSE FOSFOMYCIN TROMETAMOL VERSUS 5-DAY CEPHALEXIN REGIMEN FORTREATMENT OF UNCOMPLICATED LOWER URINARY-TRACT INFECTIONS IN WOMEN

A randomized study was conducted to assess the clinical and microbiolo gical efficacies of a single 3-g dose of fosfomycin trometamol for the treatment of uncomplicated lower urinary tract infections in women co mpared with a 5-day regimen of cephalexin at 0.5 g four times daily. O ne hundred twelve women, all of whom had documented infections with ba cteria sensitive to both antibiotics, were included. Fifty-eight women received fosfomycin trometamol, and 54 women received cephalexin. The two groups did not differ in age, severity, or duration of current ur inary tract infection, menstrual status, sexual activity, or use of co ntraceptives. Ninety percent of pathogens in the fosfomycin trometamol group and 81% in the cephalexin group were Escherichia coil (the diff erence is not significant [NS]). A clinical evaluation at the 5-day fo llow-up showed that 91% of the women in each group were free of sympto ms, while five women in each group were considered therapy failures an d were treated by another antibiotic course. A microbiological evaluat ion at the 5-day follow-up showed a 91% eradication rate in the fosfom ycin trometamol group and an 83% eradication rate in the cephalexin gr oup (NS). At the 1-month follow-up, a clinical evaluation demonstrated prolonged resolution in 86 and 78%, respectively, of the participatin g women (NS). A microbiological evaluation at 1 month demonstrated pro longed eradication in 47 (81%) women treated with fosfomycin trometamo l and in 37 (68%) women treated with cephalexin (NS). Three and six wo men, respectively, had relapsed. No adverse reactions were reported by the fosfomycin trometamol-treated women, while three women treated wi th cephalexin reported mild adverse reactions but completed the study period. Fosfomycin trometamol in a single 3-g dose is as effective as a 5-day regimen of cephalexin for the treatment of uncomplicated lower urinary tract infection in women.