Efficacy of Five Days Nitrofurantoin Therapy versus Fosfomycin Stat Dose in Clinical Resolution of Uncomplicated Urinary Tract Infections

Abstract

Objective: To compare the efficacy of 5-days Nitrofurantoin therapy versus Fosfomycin stat dose in clinical resolution of uncomplicated urinary tract infections in females of reproductive age group.

Study Design: Comparative prospective study.

Place and Duration of Study: Department of Medicine, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Apr 2019 to Mar 2020.

Methodology: A total of 498 females of reproductive age (18 years to 40 years) with lower urinary tract infection symptoms(increased urinary hesitancy, frequent micturition, tenderness at suprapubic region) and positive urine dipstick test for nitrates/leukocyte esterase test were incorporated in the study. Patients were randomly assigned to Group-A and Group-B,comprising 249 patients. Group-A was given tablet Nitrofurantoin 100mg every six hourly. Group-B was given Fosfomycin 3gstat dose. Patients were advised to follow up on days 14 and 28 of treatment to observe the clinical resolution of urinary tractinfection symptoms and bacteriologic response.

Results: Clinical resolution of urinary tract infection on the 28th day of treatment was attained in 172(69.1%) patients of the Nitrofurantoin-Group versus 140(56.2%) patients receiving Fosfomycin (p-value 0.003). Baseline urine cultures were positive in 286(57.4%) patients. Microbiologic resolution was achieved in 109 of 140(77.9%) and 100 of 146(68.4%) (p- value=0.026).

Conclusion: Among the females of reproductive age, five days of Nitrofurantoin therapy is superior to stat dose Fosfomycin in the clinical and microbiologic resolution of uncomplicated urinary tract infections.