A general practitioner multicenter study: fosfomycin trometamol single dose versus pipemidic acid multiple dose

Area of Science:

• Urology
• Infectious Diseases
• Pharmacology

Background:

• Acute cystitis is a common urinary tract infection in women.
• Current treatments often involve multi-day courses.
• Exploring single-dose antibiotic options can improve patient compliance and convenience.

Purpose of the Study:

• To evaluate the efficacy and safety of a single oral dose of fosfomycin trometamol.
• To compare fosfomycin trometamol with a standard five-day course of pipemidic acid for acute cystitis.
• To assess clinical and bacteriological outcomes at short-term and medium-term follow-up.

Main Methods:

• An open, multicenter comparative study in general practices.
• 386 women (16-75 years) with acute cystitis were enrolled.
• Treatment groups received either a single 3g dose of fosfomycin trometamol or pipemidic acid for five days.
• Diagnosis confirmed by clinical symptoms and significant bacteriuria (≥10^5 cfu/ml).
• Clinical and bacteriological evaluations at 5-10 days and 28 days post-treatment.

Main Results:

• Both treatments demonstrated comparable clinical and bacteriological efficacy.
• Short-term eradication rates: 122/146 (fosfomycin trometamol) vs. 130/143 (pipemidic acid).
• Medium-term eradication rates: 113/122 (fosfomycin trometamol) vs. 114/122 (pipemidic acid).
• Fosfomycin trometamol was associated with significantly milder and shorter-duration side effects.

Conclusions:

• Single-dose oral fosfomycin trometamol is an effective and well-tolerated treatment for acute cystitis in women.
• It presents a viable alternative to multi-day antibiotic regimens.
• The improved safety profile, particularly reduced side effect duration, enhances its therapeutic value.