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

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.

Different antibiotic regimens for treating asymptomatic bacteriuria in pregnancy

“…Two studies (Bayrak 2007;Campbell-Brown 1987) compared cephalosporins (secondgeneration cefuroxime and first-generation cephalexin) with antibiotics less associated with E. coli resistant strains, fosfomycin trometamol and pivampicillin/pivmecillinam (Miraxid®), all of which belong to pregnancy category B. Both studies, however, failed to demonstrate any significant difference in efficacy between the cephalosporins and the latter two antibiotics.…”

“…Antibiotic resistance to ampicillin is increasing (Bayrak 2007). Pivmecillinam, despite belonging to the same family of antibiotics was able to retain its activity against E. coli (Bint 1979).…”

Fosfomycin Therapy for Non-Complicated Lower Urinary Tract Infections during Pregnancy: Tanta University Experience

“…It has higher efficacy and better compliance over Nitofurantoin and other drugs making it a first choice drug for uncomplicated UTIs In pregnancy [10] Mody et al (2014). [48] The minor side effects of Fosfomycin were confirmed by Bayrak et al (2007), who revealed associated minor side effects with Fosfomycin [45].…”

Fosfomycin and Its Application in the Treatment of Multidrug-Resistant Enterobacteriaceae Infections

“…55,199 More recently, it has been compared with ceftibuten 400 mg once daily for three days, with a 95% therapeutic success rate (clinical cure and bacteriological eradication). 206 In the treatment of asymptomatic bacteriuria, a single dose of fosfomycin trometamine showed the same level of therapeutic success as cefuroxime axetyl for five days (93.2% versus 95%), 207 and as amoxicillin + clavulanic acid for seven days (eradication rate over 80% in both groups). 208 A single 2 g dose of fosfomycin trometamine was also compared with pipemidic acid 200 mg twice daily for seven days in children weighing more than 25 kg.…”