Single-dose Fosfomycin Tromethamine for Treatment of Urinary Tract Infection in Hong Kong Women: a Preliminary Prospective Study

Abstract

Objective: To investigate the clinical efficacy and side-effect profile of a single 3-g dose of fosfomycin tromethamine in the treatment of Hong Kong women having uncomplicated urinary tract infections.
Methods: This was a prospective open-labeled uncontrolled study carried out in Gynaecology Outpatient Clinic, Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong. Adult women with clinical symptoms of urinary tract infections, confirmed by microscopy and culture (colony-forming unit, >105 /ml) of midstream urine specimens, were recruited.
Results: Of 44 subjects studied, 98% returned for follow-up. Forty-eight hours after treatment with fosfomycin, the bacterial eradication rate was 86% (38/44), 91% (20/22), 100% (4/4), and 60% (3/5) for all bacteria, Escherichia coli (non-ESBL–producing strains), Escherichia coli (ESBL-producing strains), and Klebsiella, respectively. However, 19% of the subjects experienced diarrhoea.
Conclusion: Our preliminary study suggests that a single dose of fosfomycin had a high  bacterial eradication rate after 48 hours, compared to 1-week course of other antibiotics, but was associated with a high frequency of diarrhoea. Further studies using a larger sample size and longer follow-up are needed.