Lower Urinary Tract Infections (cystitis) More Likely to Resolve With Nitrofurantoin Than Fosfomycin


Women with uncomplicated lower urinary tract infections (UTIs) experience greater clinical and microbiologic resolution with nitrofurantoin than fosfomycin, according to a new study published in the Journal of the American Medical Association.

The guideline-recommended antibiotics were compared in a randomized controlled trial of 513 patients. Participants received either oral macrocrystalline nitrofurantoin (100 mg 3 times daily) for 5 days or a single 3 g dose of oral fosfomycin tromethamine.

At 28 days after treatment, 70% of nitrofurantoin recipients had complete resolution of symptoms compared with 58% of fosfomycin-treated patients. Moreover, 74% vs 63% of recipients, respectively, experienced microbiologic resolution, defined as eradication of the bacterial strain with no recurrence of bacteriuria.


Huttner A, Kowalczyk A, Turjeman A, et al. Effect of 5-Day Nitrofurantoin vs single-dose fosfomycin on clinical resolution of uncomplicated lower urinary tract infection in women: A randomized clinical trial. JAMA. doi:10.1001/jama.2018.3627 [Published online April 22, 2018.]