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Fosfomycin in a single dose versus a 7-day course of amoxicillin-clavulanate for the treatment of asymptomatic bacteriuria during pregnancy.

Abstract

The purpose of this paper was to compare the efficacy of a single dose of 3 g of fosfomycin to that of a 7-day regimen of amoxicillin-clavulanate in the treatment of asymptomatic bacteriuria during pregnancy. A randomised, prospective, interventional, analytical, longitudinal study was undertaken, in which the efficacy of two antibiotic regimens (one short and the other long) in the treatment of pregnant women with asymptomatic bacteriuria is compared. One hundred and nine patients were randomly assigned to two groups: 56 were treated with amoxicillin-clavulanate and 53 with fosfomycin. The two groups were similar in terms of co-morbidity, treatments received during pregnancy, obstetric, gynaecological and surgical history and laboratory data. The efficacy of the two regimens was similar and the eradication rate was over 80% in both groups (P = 0.720) (relative risk [RR] 1.195, 95% confidence interval [CI]: 0.451-3.165). The number of reinfections was greater in the amoxicillin-clavulanate group (P = 0.045). The secondary effects were lower in the fosfomycin group (P = 0.008). There were no significant differences in the number of persistences (P = 0.39), development of symptomatic urinary infections (P = 0.319) or recurrences (P = 0.96). Treatment with a single dose of fosfomycin is as effective as the standard course of treatment with amoxicillin-clavulanate and may be preferable due to its simpler administration and the smaller number of reinfections.

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  • Publisher Full Text

    • Authors

    Estebanez A, Pascual R, Gil V, Ortiz F, Santibáñez M, Pérez Barba C

    Institution

    Villena Health Centre, San Francisco, 1, Villena, 03400 Alicante, Spain. aestebanez@maz-prevencion.es

    Source

    European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology 28:12 2009 Dec pg 1457-64

    MeSH

    Adult
    Amoxicillin-Potassium Clavulanate Combination
    Anti-Bacterial Agents
    Bacteriuria
    Female
    Fosfomycin
    Humans
    Longitudinal Studies
    Pregnancy
    Pregnancy Complications, Infectious
    Prospective Studies
    Recurrence
    Treatment Outcome
    Young Adult

    Pub Type(s)

    Comparative Study
    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    19768649