Treatment of non - complicated lower urinary tract infection in pregnancy: Single dose fosfomycin tromethamine versus multiple dose nitrofurantoin

Gebelerde komplike olmayan üriner sistem enfeksiyonunun tedavisi: Tek doz fosfomycin tromethamine vs. multipl doz nitrofurantoin

Murat ÖZEL,Oktay KAYMAK,Nüvit BİRGİLİ,Şevki ÇELEN,Mine ERDOĞAN,Nuri DANIŞMAN

Özet

AMAÇ: Komplike olmayan alt üriner sistem enfeksiyonu olan gebe kadınlarda tek doz fosfomisin tromethamine (FT) tedavisinin yararının değerlendirilmesi GEREÇ VE YÖNTEM: Bu çalışmada, semptomatik, komplike olmayan alt üriner sistem enfeksiyonu ispatlanmış 421 gebe kadın rastgele tek doz FT(Monurol®, Zambon Group S.p.A, Milan-ITALY)(n=217) ve 7 gün süreli nitrofurantoin (n=204) tedavi gruplarına ayrıldı.İdrar kültürü tedaviden 15 gün sonra negatif ise tedavinin yararlı olduğu bulundu. BULGULAR: FT ile tedavi edilen 205(%94.5) hastada ve nitrofurantoin ile tedavi edilen 164 (%80.4) hastada mikrobiyolojik kür elde edildi (p<0.05).Patojen mikroorganizmalar baskın olarak E.coli (199 FT ve 183 NF grupta) takiben Klebsiella (18 FT and 21 NF grupta) idi. SONUÇ: Gebe kadınlarda akut alt ÜSE tedavisi gereklidir.FT gebe kadınlarda komplike olmayan alt ÜSE yönetiminde yararlı, güvenli, tek doz tedavi seçimidir.

Abstract

OBJECTIVE: To evaluate the efficacy of single-dose fosfomycin tromethamine (FT) treatment in pregnant women with uncomplicated lower urinary tract infection (UTI). STUDY DESIGN: In this study, 421 pregnant women with established, symptomatic, uncomplicated lower UTI were randomly allocated to receive either a single dose of FT (Monurol®, Zambon Group S.p.A, Milan-ITALY) (n=217) or a 7-day course of nitrofurantoin (n=204). The treatment was found to be effective if urine culture was negative 15 days after therapy. RESULTS: Microbiological cure was achieved in 205 (94.5%) patients treated with FT and 164 (80.4%) patients treated with nitrofurantoin (p<0.05). Pathogen microorganisms were predominantly E.coli (199 in FT and 183 in NF group) followed by Klebsiella (18 in FT and 21 in NF group). CONCLUSION: The treatment of acut lower UTI in pregnant women is essential. FT is an effective, safe, single dose treatment choice in the management of uncomplicated lower UTI in pregnant women