Related Experiment Video
Updated: Jan 2, 2026

An In Vitro Bladder Model of Catheter-Associated Urinary Tract Infection
Published on: June 24, 2025
Antibacterial effect of fosfomycin tromethamine on the bacteria inside urinary infection stones
Fei Song1, Chuan Liu2, Junyong Zhang1
1Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Objective:
This study sought to evaluate the antibacterial effect of fosfomycin tromethamine (FT) on the bacteria inside urinary infection stones.
Methods:
The internal structures of urinary stones were observed via scanning electron microscopy to verify the presence of internal bacteria. We randomly assigned equal numbers of patients with kidney stones who met the inclusion criteria into two groups in a prospective study and treated them with different perioperative antibiotics. One group (experimental group) was treated with FT, and the other (control group) was treated with cefuroxime sodium. All stone specimens were collected via percutaneous nephrolithotomy (PCNL). The primary infection stones were screened via a stone component analysis, 30 cases in the experimental group and 31 cases in the control group. High-performance liquid chromatography (HPLC)-mass spectrometry was used to measure the drug concentration inside the stones, the bacterial count was calculated via stone culture, and the clinical infection index were monitored for between-group comparisons.
Results:
Compared with the control group, the experimental group had a higher internal drug concentration, a higher drug sensitivity against various pathogenic bacteria, a lower bacterial colony count in the stone culture, and a lower incidence of postoperative clinical infection.
Conclusions:
FT is more effective than cefuroxime, which is commonly used during the perioperative period of urinary stones, and exerts a high antibacterial effect on these internal bacteria, and effectively reduces the probability of infection and sepsis after urinary stone surgery. FT can be used as an antibiotic during the perioperative period of urinary stones.
Insights
Fosfomycin tromethamine (FT) shows superior antibacterial effects against bacteria within urinary stones compared to cefuroxime sodium. This makes FT a more effective perioperative antibiotic for reducing infection and sepsis after urinary stone surgery.
Area of Science:
- Urology
- Infectious Diseases
- Pharmacology
Background:
- Urinary tract infections associated with kidney stones often harbor bacteria within the stone matrix.
- Perioperative antibiotic selection is crucial for preventing post-surgical infections in patients undergoing urinary stone removal.
Purpose of the Study:
- To evaluate the efficacy of fosfomycin tromethamine (FT) against bacteria residing inside urinary infection stones.
- To compare the antibacterial effect of FT with cefuroxime sodium in the perioperative management of kidney stones.
Main Methods:
- Prospective study involving patients undergoing percutaneous nephrolithotomy (PCNL) for kidney stones.
- Patients were randomized to receive either FT (experimental group) or cefuroxime sodium (control group) perioperatively.
- Bacterial presence within stones was confirmed using scanning electron microscopy; drug concentration, bacterial counts, and infection rates were analyzed.
Main Results:
- The FT group exhibited higher internal stone drug concentrations and enhanced drug sensitivity against pathogenic bacteria.
- Lower bacterial colony counts were observed in stone cultures from the FT group.
- The incidence of postoperative clinical infection was significantly lower in the FT group compared to the control group.
Conclusions:
- Fosfomycin tromethamine demonstrates superior antibacterial activity against bacteria within urinary stones compared to cefuroxime sodium.
- FT effectively reduces postoperative infection and sepsis risk, supporting its use as a perioperative antibiotic for urinary stone procedures.
Related Concept Videos
Urinary Tract Calculi III: Medical Management
Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
Urine Studies II: Urine Culture and Sensitivity Test
Urinary Tract Calculi IV: Nutrition Therapy and Prevention
Urinary Tract Calculi VI: Surgical Management

