BACKGROUND AND PURPOSE:

• Fosfomycin is a broad-spectrum antibiotic that is known to be effective against microorganisms that cause urinary tract infection (UTI) but is not commonly prescribed
• Verma et al. (Journal of Mid-Life Health, 2025) assessed the effectiveness and safety of single-dose fosfomycin vs standard antibiotics for treating UTIs in women

METHODS:

• Systematic review and meta-analysis
• Inclusion criteria
  • Randomized controlled trials
  • Studies that assessed the efficacy and safety of fosfomycin for uncomplicated UTI in women or ASB in pregnant women
• Study design
  • Asymptomatic bacteriuria (ASB) was also studied
  • Risk of bias was assessed Random and fixed effects models were used to calculate odds ratio (OR)
• Primary outcome
  • Clinical resolution of uncomplicated UTI

RESULTS:

• 22 RCTs
• A single-dose of fosfomycin was comparable with other antibiotic agents in clinical resolution of uncomplicated UTI
  • OR 1.11 (95% CI, 0.88 to 1.41)
  • I2=0% | P=0.37 | Moderate certainty
• A single dose of fosfomycin was also comparable to other antibiotics for the microbiological resolution of
  • Uncomplicated UTI
    • OR 1.02 (95% CI, 0.83 to 1.25)
    • I2=34% | P=0.88 | Moderate certainty
  • Among pregnant women with ASB, microbiological resolution rate was similar to other antibiotics
    • 5 studies | 577 participants
    • OR 0.76 (95% CI, 0.45 to 1.28)
    • I2=0% | P=0.30 | Moderate certainty
• Incidence of adverse events was similar for patients receiving fosfomycin or other antibiotics
  • OR 0.97 (95% CI, 0.77 to 1.23)
  • I2=41% | P=0.82 | Moderate certainty

CONCLUSION:

• Single-dose fosfomycin is as effective as other commonly prescribed antibiotics for uncomplicated UTI including for asymptomatic bacteriuria in pregnancy
• The authors state

In fact, prescribing a single dose of fosfomycin (3 g) as part of routine practice can promote better compliance and reduce the likelihood of antibiotic resistance

This finding highlights the importance of considering fosfomycin as a viable treatment option for uncomplicated UTIs in females

Learn More – Primary Sources:

Efficacy and Safety of Single-dose Fosfomycin for Uncomplicated Urinary Tract Infection in Women: Systematic Review and Meta-analysis