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CC BY-NC-ND 4.0 · J Lab Physicians 2021; 13(02): 118-122
DOI: 10.1055/s-0041-1729141
Original Article

Fosfomycin versus Nitrofurantoin for the Treatment of Lower UTI in Outpatients

Shraddha Sharma
1   Department of Microbiology, Govt. Medical College, Haldwani, Nainital, Uttarakhand, India
,
Pankaj Kumar Verma
2   Department of Surgery, Govt. Medical College, Haldwani, Nainital, Uttarakhand, India
,
Vinita Rawat
1   Department of Microbiology, Govt. Medical College, Haldwani, Nainital, Uttarakhand, India
,
Umesh Varshney
1   Department of Microbiology, Govt. Medical College, Haldwani, Nainital, Uttarakhand, India
,
Rajesh Kumar Singh
3   Department of Community Medicine, Govt. Medical College, Haldwani, Nainital, Uttarakhand, India
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Abstract

Introduction Fosfomycin and nitrofurantoin are increasingly being prescribed in outpatients for the oral treatment of urinary tract infection (UTI). Although ample literature is available on the in vitro sensitivity pattern of fosfomycin and nitrofurantoin in UTI cases, clinical data are scant.

Methodology Voided midstream urine, collected from patients ≥ 16 years of age of both genders with suspected sign and symptoms, was plated on cystine lactose electrolyte-deficient agar. Uropathogen was defined as an organism known to be associated with the signs and symptoms of UTI with > 105 colony forming units/mL of urine. Antimicrobial susceptibility testing was determined by Kirby-Bauer disc diffusion method. Further, for fosfomycin, agar dilution method was also performed.

Results A total of 143 patients, 47 treated with fosfomycin and 96 with nitrofurantoin, were followed for clinical outcome. The most common isolated uropathogen was Escherichia coli. In vitro susceptibility rate of uropathogens against fosfomycin and nitrofurantoin was 99.3% and 81.2%, respectively. Overall, the clinical cure rate with fosfomycin and nitrofurantoin treatment groups was 80.85% and 90.06% respectively (not statistically significant).

Conclusion Fosfomycin and nitrofurantoin showed good in vitro activity against uropathogens from lower UTI and can be used for empirical therapy in our area. Multiple confounding factors may have contributed to the discrepancy between in vitro susceptibility and clinical cure, which needs to be studied further.

Keywords

fosfomycin - nitrofurantoin - UTI


Publication History

Article published online:
30 May 2021

© 2021. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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