Fosfomycin Trometamol versus Comparator Antibiotics for the Treatment of Acute Uncomplicated Urinary Tract Infections in Women: A Systematic Review and Meta-Analysis

Cai, Tommaso; Tamanini, Irene; Tascini, Carlo; Köves, B.; Bonkat, Gernot; Gacci, Mauro; Novelli, Andréa; Horcajada, Juan Pablo; Johansen, Truls E. Bjerklund; Zanel, George

doi:10.1097/ju.0000000000000620

Cited by 23 publications

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“…Data extraction, risk of bias (RoB) assessment using the Cochrane RoB Tool and quality assessment using the Grading of Recommendations, Assessment, Development and Education (GRADE) [ 22 ] approach have been performed by two reviewers (T.C., I.T.) working independently, as described in our previous study [ 23 ].…”

Section: Methodsmentioning

confidence: 99%

“…The primary endpoint was clinical or microbiological success, defined as the complete (cure) and/or non-complete (improvement) resolution of symptoms at the end of treatment, or microbiological resolutions, in line with the trialists’ definition. Microbiological success (eradication) was defined as the presence of a negative urine culture at the end of treatment [ 23 ]. Secondary endpoints included the presence of adverse events, which was defined as any adverse event that was reported at any time during the study period [ 23 ].…”

Section: Methodsmentioning

confidence: 99%

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Xyloglucan, Hibiscus and Propolis in the Management of Uncomplicated Lower Urinary Tract Infections: A Systematic Review and Meta-Analysis

et al. 2021

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Background: In the era of antibiotic resistance, an antibiotic-sparing approach presents an interesting alternative treatment of uncomplicated cystitis in women. Our aim is to perform a systematic review and meta-analysis to compare the effectiveness and safety profile of a medical device containing xyloglucan, hibiscus and propolis (XHP) in women with uncomplicated cystitis. Methods: Relevant databases were searched using methods recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The primary endpoint was clinical or microbiological success, defined as the complete (cure) and/or non-complete (improvement) resolution of symptoms at the end of treatment, or microbiological resolutions. Results: After screening 21 articles, three studies were included, recruiting a total of 178 patients. All three studies used placebo as comparator. A statistically significant difference was found in terms of clinical or microbiological resolution between the medical device and the comparator (3 RCTs, 178 patients, OR: 0.13; 95% CI: 0.05–0.33; p < 0.0001). No clinically significant adverse effects have been reported. Conclusion: A medical device containing xyloglucan, hibiscus and propolis is superior to comparator regimens in terms of clinical effectiveness in adult women with microbiologically confirmed or clinical suspicion of uncomplicated cystitis and is associated with a high patient compliance.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Xyloglucan, Hibiscus and Propolis in the Management of Uncomplicated Lower Urinary Tract Infections: A Systematic Review and Meta-Analysis

et al. 2021

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“…Single-dose fosfomycin was noted to have improved compliance and lower risk of antibiotic resistance, though this was not specifically reported in detail in this review. 16 Case conclusion: Based on this study, you discuss treatment with fosfomycin. You treat her with one dose of fosfomycin 3 g. Her symptoms resolve quickly and she has a long period following initiation of vaginal estrogen during which she is infection-free and symptom-free.…”

Section: Antibiotic Selection For Uncomplicated Utismentioning

confidence: 96%

“…A systematic review and meta-analysis published in the Journal of Urology compared the efficacy and safety of fosfomycin to other antibiotics in women with acute, uncomplicated UTIs. 16 A total of 539 articles were screened, of which 15 were included in the meta-analysis, with a total of 2295 patients. All trials compared a single dose of fosfomycin 3 g to another antibiotic (fluoroquinolones in five, trimethoprim or cotrimoxazole in three, nitrofurantoin in three, and beta-lactams in two).…”

Section: Antibiotic Selection For Uncomplicated Utismentioning

confidence: 99%

Practice-changing publications in functional urology: A case-based approach

Nguyen

Cox

2021

CUAJ

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“…12 13 The rationale for this strategy is based on the narrow spectrum of aetiologic agents causing acute cystitis and knowledge of their local antimicrobial resistance patterns. 14 Over the last years, the use of fosfomycin as the preferred therapy for these infections has significantly increased in Spain. However, more than half of the Spanish doctors prefer the use of short-course therapies over single-dose therapy.…”

Section: Introductionmentioning

confidence: 99%

Clinical effectiveness and bacteriological eradication of three different Short-COurse antibiotic regimens and single-dose fosfomycin for uncomplicated lower Urinary Tract infections in adult women (SCOUT study): study protocol for a randomised clinical trial

et al. 2021

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IntroductionUncomplicated lower urinary tract infections (uLUTI) are a common problem in primary care. Current local guidelines recommend the use of a single 3 g dose of fosfomycin. However, most general practitioners (GP) prefer short-course therapies to single-dose therapy. No study has compared head-to-head short-course antimicrobial agents for uLUTIs. Therefore, the aim of this randomised clinical trial is to compare three different short-course antibiotic therapies with a single-dose of fosfomycin for these infections.Methods and analysisThis will be a pragmatic, multicentre, parallel group, open trial. Women aged 18 or older and with symptoms of uLUTI and a positive urine dipstick analysis will be randomised to one of the following four groups: a single dose of 3 g of fosfomycin, 2 days of 3 g of fosfomycin o.d., 3 days of pivmecillinam 400 mg three times per day (t.i.d) or 5 days of nitrofurantoin 100 mg t.i.d. A total sample of 1120 patients was calculated. The primary endpoint is clinical effectiveness at day 7, defined as cure of symptoms reported by the patients in a diary including four symptoms: dysuria, urgency, frequency and suprapubic pain, which will be scored on a 4-point severity scale (not present/mild/moderate/severe). Follow-up visits are scheduled at days 7 (phone call), 14 and 28 for assessing evolution. Urine samples will be collected in the three on-site visits and urine cultures performed. If positive, antibiograms for the three antibiotics studied will be performed. Bacterial eradication will be measured at days 14 and 28.Ethics and disseminationThe study was approved by the Ethical Board of IDIAP Jordi Gol (reference number: 21/173-AC) and Spanish Agency of Medicines and Medical Devices. The findings of this trial will be disseminated through research conferences and peer-review journals.Trial registration numberNCT04959331; EudraCT Number: 2021-001332-26.Time scheduleJanuary 2022 to April 2023.

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Fosfomycin Trometamol versus Comparator Antibiotics for the Treatment of Acute Uncomplicated Urinary Tract Infections in Women: A Systematic Review and Meta-Analysis

Cited by 23 publications

References 0 publications

Xyloglucan, Hibiscus and Propolis in the Management of Uncomplicated Lower Urinary Tract Infections: A Systematic Review and Meta-Analysis

Xyloglucan, Hibiscus and Propolis in the Management of Uncomplicated Lower Urinary Tract Infections: A Systematic Review and Meta-Analysis

Practice-changing publications in functional urology: A case-based approach

Clinical effectiveness and bacteriological eradication of three different Short-COurse antibiotic regimens and single-dose fosfomycin for uncomplicated lower Urinary Tract infections in adult women (SCOUT study): study protocol for a randomised clinical trial

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