Introduction. Antibiotics represent the main drugs for the treatment and prevention of recurrent lower urinary tract infections (UTIs). At the same time, there is no consensus regarding the duration of therapy and the interval between courses.
Material and methods. A total of 50 women aged 18 to 65 years (mean age 44.6±13.2 years) with recurrent lower UTIs in the acute stage were treated. All patients were prescribed fosfomycin trometamol (Fosfomycin Esparma, Esparma GmbH, Germany) at a dose of 3 g once every 10 days for 3 months. The changes of clinical and laboratory parameters were evaluated on the 3rd day after the first administration of fosfomycin, and then after 1, 3 and 6 months from the start of treatment.
Results. A decrease in the severity of clinical manifestations of cystitis was seen on the next day after first administration of fosfomycin. By the 3rd day, the ACSS score decreased from the initial 9.2±2.1 to 1.4±1.0 (p<0.001), while the average urinary frequency changed from 12.3±2.3 to 7.5±1.4 (p<0.05). After 3 months of therapy, the clinical results virtually did not differ from results on the 3rd day. The therapy was well tolerated; adverse events were noted in 10 patients, but they didn’t result in discontinuation of the drug. During follow-up for 3 months after the completion of therapy, 47 (94%) women didn’t have recurrence of lower UTI.
Conclusion: the results of the study suggest a high efficiency and good tolerability of fosfomycin when it is prescribed according to specific scheme for the treatment and prevention of recurrent lower UTIs in women.

Keywords: recurrent lower urinary tract infections, cystitis, fosfomycin, antibiotic therapy, antibiotic resistance