title: A comparison between single-dose fosfomycin trometamol (Monuril) and a 5-day course of trimethoprim in the treatment of uncomplicated lower urinary tract infection in women.
abstract: This study is a comparison of the microbiological and clinical efficacy of single-dose fosfomycin trometamol therapy and a 5 day course of trimethoprim in the treatment of uncomplicated urinary tract infection in female patients. Urine dip-slide samples were obtained from 547 female patients aged 18-65 by 22 General Practitioners (GPs) participating in the study from 21 centres in the UK. All patients were diagnosed as having a urinary tract infection by their GP on the basis of history and clinical examination. Patients were randomised to receive either single dose fosfomycin trometamol or a 5 day course of trimethoprim in a 2:1 ratio. Patients who had significant bacteriuria (> or = 10(5) c.f.u/ml) at the first visit (300) were included in the microbiological analysis. The two commonest urinary pathogens isolated were Escherichia coli and Staphylococcus saprophyticus. Trimethoprim resistance was more frequent amongst E. coli isolates whereas fosfomycin trometamol resistance was more common amongst S. saprophyticus isolates. Microbiological cure was demonstrated in 83.3% of the trimethoprim treated group and 83% of the fosfomycin trometamol treated group. Persistence of the infecting bacteria was seen in 17% of each treatment arm.
authors.affiliation: Department of Medical Microbiology, London Hospital Medical College, UK.
authors.forename: M A
authors.initials: MA
authors.lastname: Minassian
authors.forename: D A
authors.initials: DA
authors.lastname: Lewis
authors.forename: D
authors.initials: D
authors.lastname: Chattopadhyay
authors.forename: B
authors.initials: B
authors.lastname: Bovill
authors.forename: G J
authors.initials: GJ
authors.lastname: Duckworth
authors.forename: J D
authors.initials: JD
authors.lastname: Williams
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000892:Anti-Infective Agents, Urinary / Q000494:pharmacology / Q000627:therapeutic use*; D002954:Citrobacter / Q000187:drug effects / Q000302:isolation & purification; D004334:Drug Administration Schedule; D013293:Enterococcus faecalis / Q000187:drug effects / Q000302:isolation & purification; D004926:Escherichia coli / Q000187:drug effects / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy; D005194:Family Practice; D005260:Female; D005578:Fosfomycin / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007709:Klebsiella / Q000187:drug effects / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011513:Proteus mirabilis / Q000187:drug effects / Q000302:isolation & purification; D013203:Staphylococcal Infections / Q000188:drug therapy; D013210:Staphylococcus / Q000187:drug effects / Q000302:isolation & purification; D014295:Trimethoprim / Q000494:pharmacology / Q000627:therapeutic use*; D006113:United Kingdom; D014552:Urinary Tract Infections / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D000892:Anti-Infective Agents, Urinary; D005578:Fosfomycin; D014295:Trimethoprim