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. 2023 Oct 31;14(5):e0167723.
doi: 10.1128/mbio.01677-23. Epub 2023 Sep 12.

Daily fosfomycin versus levofloxacin for complicated urinary tract infections

Nadine Rouphael  1 , Patricia Winokur  2 , Michael C Keefer  3 , Jessica Traenkner  1 , Ana Drobeniuc  1 , Yohei Doi  4   5 , Sonal Munsiff  3 , Vance G Fowler  5   6 , Scott Evans  5   7 , Randolph E Oler  8 , Bonifride Tuyishimire  8 , Marina Lee  9 , Varduhi Ghazaryan  9 , Henry F Chambers  5   10 ; DMID 15-0045 study group
Collaborators, Affiliations

Daily fosfomycin versus levofloxacin for complicated urinary tract infections

Nadine Rouphael et al. mBio. .

Abstract

Concerns over resistance and safety have been identified in the current treatment regimen for complicated urinary tract infections. Fosfomycin is a drug that is routinely used for the treatment of uncomplicated cystitis. This study shows that fosfomycin could be an oral alternative as step-down therapy for the treatment of complicated urinary tract infections, with a clinical cure rate comparable to levofloxacin but a lower microbiological success rate 3 weeks from start of antibiotics.

Keywords: complicated UTI; fosfomycin; oral antibiotic.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIG 1
FIG 1
Schematic of the study design. QD, once daily; PO, orally; BID, twice a day; DS, double strength.
FIG 2
FIG 2
Consolidated standards of reporting trials (CONSORT) diagram. CC, complete cases.
FIG 3
FIG 3
Distribution of uropathogens at baseline in the microbiological intention-to-treat population.
FIG 4
FIG 4
Solicited grade 2 and 3 adverse events in subjects who received at least one dose of study drug by maximum severity and by strategy (Strategy 1: initial or step-down to oral fosfomycin; Strategy 2: initial or step-down to oral levofloxacin).
See this image and copyright information in PMC

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