Monuril in lower uncomplicated urinary tract infections in adults

Fosfomycin trometamol is a new fosfomycin salt with much improved intestinal absorbtion, thus providing high levels of the drug both in serum and urine. The range of activity and the pharmacokinetic characteristics of this new salt emphasize its usefulness in therapy of urinary tract infections (UTIs), either as a single dose or in short courses. In a multicentric, open, non-controlled trial, fosfomycin trometamol was employed in the treatment of 365 UTIs (84 males and 281 females, of whom 13 were pregnant). 144 UTIs were community acquired, while 221 were hospital acquired; 48 were diagnosed as asymptomatic bacteriurias, 201 as lower uncomplicated symptomatic UTIs, 49 as lower complicated UTIs, 59 as recurrent lower symptomatic UTIs, and 8 as cystopyelitis. The drug was administered as a single dose, i.e. 3 g at once, in 198 cases and in short courses, i.e. 3 g daily for 2-3 days (in a few patients, though, for 11 days) in 167 cases. High success rates were attained using the single dose in asymptomatic bacteriurias (78.1%), in lower uncomplicated symptomatic UTIs (89.5%), as well as in UTIs of the female (85.3%) and community-acquired UTIs (97.4%). In all these cases, the single-dose regimen seems to be the most rational form of clinical use, since the multiple-dose regimen did not add any further advantage. In infections of the male, or in hospital-acquired or complicated UTIs, short therapy courses gave better results. The drug was well tolerated, even by pregnant women, and clinically irrelevant side effects were recorded in a small number of patients.