Real-Life Comparison of Fosfomycin to Nitrofurantoin for the Treatment of Uncomplicated Lower Urinary Tract Infection in Women
In this study, we compared the failure rates of fosfomycin and nitrofurantoin for uncomplicated urinary tract infections. We used Meuhedet Health Services’ large database to collect data on all female patients, older than 18 years, who were prescribed either antibiotic during 2013–2018. Treatment fa...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/11/4/1019 |
| _version_ | 1797606310904070144 |
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| author | Asher Shafrir Yonatan Oster Michal Shauly-Aharonov Jacob Strahilevitz |
| author_facet | Asher Shafrir Yonatan Oster Michal Shauly-Aharonov Jacob Strahilevitz |
| author_sort | Asher Shafrir |
| collection | DOAJ |
| description | In this study, we compared the failure rates of fosfomycin and nitrofurantoin for uncomplicated urinary tract infections. We used Meuhedet Health Services’ large database to collect data on all female patients, older than 18 years, who were prescribed either antibiotic during 2013–2018. Treatment failure was a composite endpoint of hospitalization, emergency-room visit, IV antibiotic treatment, or prescription of a different antibiotic, within seven days of the initial prescription. Reinfection was considered when one of these endpoints appeared 8–30 days following the initial prescription. We found 33,759 eligible patients. Treatment failure was more common in the fosfomycin group than the nitrofurantoin group (8.16% vs. 6.87%, <i>p</i>-value < 0.0001). However, reinfection rates were higher among patients who received nitrofurantoin (9.21% vs. 7.76%, <i>p</i>-value < 0.001). Among patients younger than 40 years, patients treated with nitrofurantoin had more reinfections (8.68% vs. 7.47%, <i>p</i> value = 0.024). Treatment failure rates were mildly higher in patients treated with fosfomycin, despite having less reinfections. We suggest that this effect is related to a shorter duration of treatment (one vs. five days) and encourage clinicians to be more patient before declaring fosfomycin failure and prescribing another antibiotic. |
| first_indexed | 2024-03-11T05:13:24Z |
| format | Article |
| id | doaj.art-c5793eb6191d4143870beae824f18aae |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-11T05:13:24Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-c5793eb6191d4143870beae824f18aae2023-11-17T18:25:21ZengMDPI AGBiomedicines2227-90592023-03-01114101910.3390/biomedicines11041019Real-Life Comparison of Fosfomycin to Nitrofurantoin for the Treatment of Uncomplicated Lower Urinary Tract Infection in WomenAsher Shafrir0Yonatan Oster1Michal Shauly-Aharonov2Jacob Strahilevitz3Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190401, IsraelFaculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190401, IsraelThe Jerusalem College of Technology, Jerusalem 9116001, IsraelFaculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190401, IsraelIn this study, we compared the failure rates of fosfomycin and nitrofurantoin for uncomplicated urinary tract infections. We used Meuhedet Health Services’ large database to collect data on all female patients, older than 18 years, who were prescribed either antibiotic during 2013–2018. Treatment failure was a composite endpoint of hospitalization, emergency-room visit, IV antibiotic treatment, or prescription of a different antibiotic, within seven days of the initial prescription. Reinfection was considered when one of these endpoints appeared 8–30 days following the initial prescription. We found 33,759 eligible patients. Treatment failure was more common in the fosfomycin group than the nitrofurantoin group (8.16% vs. 6.87%, <i>p</i>-value < 0.0001). However, reinfection rates were higher among patients who received nitrofurantoin (9.21% vs. 7.76%, <i>p</i>-value < 0.001). Among patients younger than 40 years, patients treated with nitrofurantoin had more reinfections (8.68% vs. 7.47%, <i>p</i> value = 0.024). Treatment failure rates were mildly higher in patients treated with fosfomycin, despite having less reinfections. We suggest that this effect is related to a shorter duration of treatment (one vs. five days) and encourage clinicians to be more patient before declaring fosfomycin failure and prescribing another antibiotic.https://www.mdpi.com/2227-9059/11/4/1019urinary tract infectionsreal lifefosfomycinnitrofurantoinadherence |
| spellingShingle | Asher Shafrir Yonatan Oster Michal Shauly-Aharonov Jacob Strahilevitz Real-Life Comparison of Fosfomycin to Nitrofurantoin for the Treatment of Uncomplicated Lower Urinary Tract Infection in Women Biomedicines urinary tract infections real life fosfomycin nitrofurantoin adherence |
| title | Real-Life Comparison of Fosfomycin to Nitrofurantoin for the Treatment of Uncomplicated Lower Urinary Tract Infection in Women |
| title_full | Real-Life Comparison of Fosfomycin to Nitrofurantoin for the Treatment of Uncomplicated Lower Urinary Tract Infection in Women |
| title_fullStr | Real-Life Comparison of Fosfomycin to Nitrofurantoin for the Treatment of Uncomplicated Lower Urinary Tract Infection in Women |
| title_full_unstemmed | Real-Life Comparison of Fosfomycin to Nitrofurantoin for the Treatment of Uncomplicated Lower Urinary Tract Infection in Women |
| title_short | Real-Life Comparison of Fosfomycin to Nitrofurantoin for the Treatment of Uncomplicated Lower Urinary Tract Infection in Women |
| title_sort | real life comparison of fosfomycin to nitrofurantoin for the treatment of uncomplicated lower urinary tract infection in women |
| topic | urinary tract infections real life fosfomycin nitrofurantoin adherence |
| url | https://www.mdpi.com/2227-9059/11/4/1019 |
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