Verma Tania, Manhas Gaurav Singh, Manhas Rameshwar Singh
Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Jammu, Jammu and Kashmir, India.
Department of Radiology, Government Medical College, Jammu, Jammu and Kashmir, India.
J Midlife Health. 2025 Apr-Jun;16(2):124-136. doi: 10.4103/jmh.jmh_77_24. Epub 2025 Jun 23.
In this meta-analysis and systematic review, the effectiveness and safety of single-dose fosfomycin were evaluated in comparison to other antibiotics for treating uncomplicated urinary tract infections (UTIs) in women, including asymptomatic bacteriuria (ASB) in pregnant women. Two independent reviewers conducted an electronic search on until December 2023 to search for randomized controlled trials that studied the efficacy and safety of fosfomycin for management of uncomplicated UTI in women or ASB in pregnant women and included those that fulfilled the eligibility criteria. The results showed that single-dose fosfomycin was comparable with other antibiotic agents in clinical resolution of uncomplicated UTI (odds ratio [OR]: 1.11, 95% confidence interval [CI] 0.88-1.41, = 0%, = 0.37, moderate certainty). Moreover, single-dose fosfomycin was equal to other antibiotics in the microbiological resolution of uncomplicated UTI (OR: 1.02, 95% CI: 0.83-1.25, = 34%, = 0.88, moderate certainty) and ASB among nonpregnant women (OR: 0.76, 95% CI: 0.45-1.28, = 0%, = 0.30, moderate certainty). The incidence of adverse events too was similar in patients receiving fosfomycin or other antibiotics (OR: 0.97, 95% CI: 0.77-1.23, = 41%, = 0.82, moderate certainty). Administering a single dose of fosfomycin is just as safe and effective as other antibiotics in treating uncomplicated UTIs in women. Prescribing a single dose of fosfomycin (3 g) as a regular practice may result in higher compliance rates and a reduced likelihood of antibiotic resistance.
在这项荟萃分析和系统评价中，将单剂量磷霉素与其他抗生素相比，评估了其治疗女性单纯性尿路感染（UTI）的有效性和安全性，包括孕妇无症状菌尿（ASB）。两名独立评审员进行了电子检索，直至2023年12月，以查找研究磷霉素治疗女性单纯性UTI或孕妇ASB的疗效和安全性且符合纳入标准的随机对照试验。结果显示，在单纯性UTI的临床缓解方面，单剂量磷霉素与其他抗生素相当（优势比[OR]：1.11，95%置信区间[CI] 0.88 - 1.41，I² = 0%，P = 0.37，中等确定性）。此外，在单纯性UTI的微生物学缓解方面（OR：1.02，95% CI：0.83 - 1.25，I² = 34%，P = 0.88，中等确定性）以及非孕妇ASB方面（OR：0.76，95% CI：0.45 - 1.28，I² = 0%，P = 0.30，中等确定性），单剂量磷霉素与其他抗生素相当。接受磷霉素或其他抗生素治疗的患者不良事件发生率也相似（OR：0.97，95% CI：0.77 - 1.23，I² = 41%，P = 0.82，中等确定性）。在治疗女性单纯性UTI方面，给予单剂量磷霉素与其他抗生素一样安全有效。常规开具单剂量磷霉素（3克）可能会提高依从率并降低抗生素耐药的可能性。
