TY - JOUR
TI - Fosfomycin versus other antibiotics for the treatment of cystitis: a
meta-analysis of randomized controlled trials
AU - Falagas, Matthew E.
AU - Vouloumanou, Evridiki K.
AU - Togias, Antonios G.
AU - and Karadima, Maria
AU - Kapaskelis, Anastasios M.
AU - Rafailidis, Petros
AU - I.
AU - Athanasiou, Stavros
JO - The Journal of antimicrobial chemotherapy
PY - 2010
VL - 65
TODO - 9
SP - 1862-1877
PB - Oxford University Press
SN - null
TODO - 10.1093/jac/dkq237
TODO - fosfomycin tromethamine; microbiological eradication; pregnancy; safety
TODO - Cystitis is a common infection. The alarmingly high resistance rates
exhibited by contemporary uropathogens necessitate the re-evaluation of
old antibiotics.
To evaluate the effectiveness and safety of fosfomycin compared with
other antibiotics for the treatment of patients with cystitis.
We performed a meta-analysis of randomized controlled trials (RCTs),
generated from searches performed in PubMed, Scopus and Cochrane
CENTRAL, which involved patients with cystitis treated with fosfomycin
versus other antibiotics.
Twenty-seven trials (eight double-blind) were included. Sixteen of these
27 trials involved exclusively non-pregnant female patients, 3 involved
adult mixed populations of older age, 5 involved pregnant patients and 3
involved paediatric patients. Regarding clinical success, no difference
was found in the comprehensive analysis regarding all comparators
combined [10 RCTs, 1657 patients, risk ratio (RR) = 1.00, 95%
confidence interval (CI) = 0.98-1.03] in trials involving non-pregnant
females and in trials involving mixed populations. Insufficient relevant
data were provided from trials involving paediatric and pregnant
patients. No difference between fosfomycin and comparators was also
found in all comparisons regarding the remaining effectiveness outcomes
(namely microbiological success/relapse/re-infection). Fosfomycin had a
comparable safety profile with the evaluated comparators in non-pregnant
women, mixed and paediatric populations, whereas it was associated with
significantly fewer adverse events in pregnant women (4 RCTs, 507
patients, RR = 0.35, 95% CI = 0.12-0.97).
In the era of high drug resistance rates, reported even among
community-acquired uropathogens, fosfomycin may provide a valuable
alternative option for the treatment of cystitis in non-pregnant and
pregnant women and in elderly and paediatric patients.
ER -