Русский
Experience of using the antibacterial drug Fosfomycin Esparma for the treatment of acute uncomplicated cystitis in women
DOI: https://dx.doi.org/10.18565/urology.2019.4.20-25
I.A. Aboyan, Yu.N. Orlov, O.A. Voloshina, N.V. Orlov, D.S. Pavlov
1) MBUZ Clinical and diagnostic Center “Zdorovie”, Rostov-on-Don, Russia; 2) CGSEN FKUZ “Medical Unit of Ministry of Internal Affairs of MVD of Russia in Rostov Region”, Rostov-on-Don, Russia; 3) FGBOU VO Rostov State Medical University of the Ministry of Health of Russian Federation, Moscow, Russia
Aim. To evaluate the efficacy and safety of the antibacterial drug fosfomycin trometamol (Fosfomycin Esparma) in women of reproductive age with acute uncomplicated cystitis.
Materials and methods. In order to assess the efficacy and safety of using fosfomycin trometamol (Fosfomycin Esparma), a prospective, non-randomized, uncontrolled study involving 32 women with acute uncomplicated cystitis was carried out. The average patients’ age was 27.3±3.1 years. Before the study, all women underwent a general clinical, bacteriological, and ultrasound examination. Inclusion criteria was the presence of pathognomonic symptoms of acute uncomplicated cystitis. Exclusion criteria were as following: complicated urinary tract infection, anatomical and functional disorders of the urinary tract, comorbidities. All patients were prescribed a study drug at a dose of 3 g, once. The efficiency of therapy was evaluated on days 3 and 14 after administration of Fosfomycin Esparma based on clinical and microbiological cure and safety.
Results. The only bacterial pathogen isolated from the urine was E. coli. In 4 cases (12.5%) strains produced extended-spectrum β-lactamase. The sensitivity of E. coli to fosfomycin, piperacillin/tazobactam, amikacin and meropenem was 100%. A resistance to ampicillin was 15.6%, compared to 9.4% for levofloxacin and norfloxacin and 12% for cefotaxime, ceftazidime, cefpoxin. By the 3rd day after receiving fosfomycin, the symptoms of cystitis were resolved in all patients. On day 14, according to the results of the urine culture, there was no growth of bacteria. During the follow-up period, no significant side effects was detected.
Conclusion. Our study showed that antibacterial drug Fosfomycin Esparma in women of reproductive age with acute uncomplicated cystitis is effective and safe. Maintaining a high sensitivity to fosfomycin allows us to recommend this drug as an empirical antibiotic therapy in this cohort of patients.
Materials and methods. In order to assess the efficacy and safety of using fosfomycin trometamol (Fosfomycin Esparma), a prospective, non-randomized, uncontrolled study involving 32 women with acute uncomplicated cystitis was carried out. The average patients’ age was 27.3±3.1 years. Before the study, all women underwent a general clinical, bacteriological, and ultrasound examination. Inclusion criteria was the presence of pathognomonic symptoms of acute uncomplicated cystitis. Exclusion criteria were as following: complicated urinary tract infection, anatomical and functional disorders of the urinary tract, comorbidities. All patients were prescribed a study drug at a dose of 3 g, once. The efficiency of therapy was evaluated on days 3 and 14 after administration of Fosfomycin Esparma based on clinical and microbiological cure and safety.
Results. The only bacterial pathogen isolated from the urine was E. coli. In 4 cases (12.5%) strains produced extended-spectrum β-lactamase. The sensitivity of E. coli to fosfomycin, piperacillin/tazobactam, amikacin and meropenem was 100%. A resistance to ampicillin was 15.6%, compared to 9.4% for levofloxacin and norfloxacin and 12% for cefotaxime, ceftazidime, cefpoxin. By the 3rd day after receiving fosfomycin, the symptoms of cystitis were resolved in all patients. On day 14, according to the results of the urine culture, there was no growth of bacteria. During the follow-up period, no significant side effects was detected.
Conclusion. Our study showed that antibacterial drug Fosfomycin Esparma in women of reproductive age with acute uncomplicated cystitis is effective and safe. Maintaining a high sensitivity to fosfomycin allows us to recommend this drug as an empirical antibiotic therapy in this cohort of patients.
Keywords: fosfomycin trometamol, acute uncomplicated cystitis, antibiotic resistance, antibacterial therapy, urinary tract infection
About the Autors
Corresponding author: Yu.N. Orlov – urologist, MBUZ Clinical and diagnostic Center “Zdorovie”, Rostov-on-Don, Russia;
e-mail: orlovurolog@gmail.com
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